Correlation of Symptoms, Clinical Signs, and Biomarkers of Inflammation in Postsurgical Chronic Rhinosinusitis

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Abstract

Objective:

The study aimed to evaluate symptoms described by patients with chronic rhinosinusitis with polypoid changes/nasal polyps and their correlation with computed tomography (CT), nasal endoscopy, and intranasal biomarkers.

Study Design:

Prospective multicenter study symptom data from postsurgical adult chronic rhinosinusitis study participants with recurrent disease refractory to medical therapy were analyzed in comparison with objective data.

Methods:

Using logistic regression analysis, participant-rated 16-question surveys from 258 participants were assessed for correlation with nasal endoscopy scores, CT percentage of sinus occlusion, and intranasal biomarkers of fungal antigens (Alternaria and Aspergillus), eosinophilic inflammation (eosinophil-derived neurotoxin [EDN] and major basic protein [MBP]), and inflammatory cytokines (interleukins 5 and 13).

Results:

Study participant assessments revealed increased CT occlusion in participants presenting with greater inability to smell (P < .019). Mucosal inflammation identified on nasal endoscopy was positively correlated with congestion (P < .028), runny nose (P < .002), and ear pain (P < .007). Elevated EDN was positively correlated in patients with bothersome congestion (P < .031) and runny nose (P < .011). Sneezing was positively correlated with multiple markers: Alternaria (P < .024), interleukin-13 (P < .027), MBP (P < .034), and interleukin-5 (P < .019).

Conclusion:

Nasal endoscopy, not CT imaging, has the strongest correlation with the 2 cardinal symptoms of congestion and runny nose in CRS patients; these correlate with biomarkers of eosinophilic inflammation.

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