The impact of asthma on quality of life and symptoms in patients with chronic rhinosinusitis.

Objective: Several studies on the health-related quality of life (HRQL) and imaging scores in patients with chronic rhinosinusitis (CRS) indicated asthma as a comorbidity with a significant impact on subjective and objective outcomes. However, these studies did not adjust the data for other confounders which may interfere with the CRS outcomes. This study aims to evaluate how asthma influences clinical symptoms, imaging scores and HRQL in CRS patients.Methods: The study enrolled CRS patients and collected data about asthma status, clinical symptoms, allergic sensitization, computed tomography (CT) and 22-item SinoNasal Outcome questionnaire (SNOT-22). Matching pairs of asthmatic and non-asthmatic CRS patients were defined based on age, gender and nasal polyp presence. The difference between pairs in clinical symptoms, CT and SNOT-22 was then analyzed. The study enrolled mild to moderate asthma patients.Results: From 250 CRS patients, 65 (26%) had had asthma. We found 60 CRS asthma and CRS non-asthma pairs based on age, gender and nasal polyp presence. There was no difference in total SNOT-22 score between asthma (46.5) and non-asthma (43.5) CRS groups(p < 0.357). There were more patients with allergy positive medical history in the asthma group (66.1%) when we stratified for CRS phenotypes, gender and age. When comparing the visual analogue scale (VAS) scores for clinical symptoms, smell (p < 0.013) was the only symptom significantly worse in the CRS asthma group. Although there was no difference in Lund-Mackay score, there was a slightly higher osteitis score in the CRS asthma group (5.21 versus 3.45; p= 0.059).Conclusion: CRS patients with asthma have significantly worse impairment of smell and taste when compared to non-asthmatic CRS patients. This is the only significant difference which is independent of nasal polyp presence, gender, age and allergy.