Rinitis, poliposis nasal y su relación con el asma

espanolEl objetivo de esta revision es facilitar al neumologo el manejo de las enfermedades de la via respiratoria superior ligadas a la via respiratoria inferior, especialmente al asma, unidas por una epidemiologia, una clinica y un mecanismo inflamatorio comunes e interrelacionados. El documento recoge las definiciones de los diferentes fenotipos nasosinusales ligados al asma: rinitis alergica o no alergica y rinosinusitis cronica con o sin polipos nasales. Asimismo se recogen los criterios diagnosticos y su nivel de gravedad. Se dedica especial atencion a los dos sindromes principales asociados al asma: 1) rinitis alergica, la patologia mas frecuente, y 2) rinosinusitis cronica con polipos nasales, la patologia mas ligada al asma grave. En sintesis, en el manejo del asma debe valorarse siempre la via respiratoria superior con la finalidad de un diagnostico unificado y un tratamiento integral de la via respiratoria unica. EnglishThe aim of this review is to assist pulmonologists in the management of diseases involving both the upper and lower respiratory tract that are linked by a common, interrelated epidemiology, clinical signs and symptoms, and inflammatory mechanism − asthma, in particular. The document discusses the definitions of the various sinonasal phenotypes associated with asthma: allergic and non-allergic rhinitis and chronic rhinosinusitis with or without nasal polyps. Diagnostic criteria and severity levels are also listed. Particular attention has been given to the 2 main syndromes associated with asthma: (i) allergic rhinitis, the most common, and (ii) chronic rhinosinusitis with nasal polyps, the disease most closely associated with severe asthma. To summarize, the upper respiratory tract should always be evaluated in order to achieve a single diagnosis and comprehensive treatment of the “united airway”.