Radiological score, asthma and NSAID-exacerbated respiratory disease predict relapsing chronic rhinosinusitis

IF 4.6 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2025-04-02 DOI:10.1002/clt2.70043

Markus Lilja, Anni Koskinen, Sari Hammarèn-Malmi, Anu Laulajainen-Hongisto, Jura Numminen, Jyri Myller, Seija Vento, Elina Penttila, Maija Hytönen, Paula Virkkula, Peter W. Hellings, Sven F. Seys, John Lee, Heini Huhtala, Johanna Sahlman, Sanna Toppila-Salmi

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Abstract

Objectives

The aim was to evaluate the predictive potential of Sinonasal Radiological (SR) and the Lund-Mackay (LM) score of sinus computed tomography (CT) scans on postoperative relapses of chronic rhinosinusitis (CRS).

Materials and Methods

CRS patients (n = 483, 12–80 years) underwent routine sinus CT scans. The SR score was defined by obstructed frontal recess (0 = no, 1 = yes) and visualization of middle and inferior turbinate (0 = anatomy can be easily visualized, 1 = anatomy cannot be easily visualized) on each side (a total of 0–6 points). Associations were analyzed by nonparametric, survival and Cox's proportional hazard models.

Results

Revision endoscopic sinus surgery (ESS) was performed in 133 (28.0%) patients on average (min–max) of 3.2 (0–12) years after performing the sinus CT scans. Of the 408 patients who underwent the baseline ESS, high preoperative SR or LM scores significantly predicted revision ESS (p < 0.001) and peroral corticosteroid courses purchased during the follow-up (p = 0.009 and p < 0.001, respectively for SR- and LM-scores). In multivariable analysis, both SR score and asthma and/or NSAID exacerbated respiratory disease (N-ERD) were significantly associated with revision ESS risk (p = 0.035, p = 0.007, respectively).

Conclusion

LM and SR and a history of asthma or N-ERD predict CRS relapses, which may help in decision-making.

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放射学评分、哮喘和非甾体抗炎药加重的呼吸系统疾病可预测慢性鼻窦炎复发

目的评价鼻窦CT扫描（CT）鼻窦放射学（SR）和隆德-麦凯（LM）评分对慢性鼻窦炎（CRS）术后复发的预测潜力。材料与方法CRS患者（483例，年龄12 ~ 80岁）行常规鼻窦CT扫描。SR评分以每侧额隐窝阻塞（0 =否，1 =是）和中、下鼻甲可见（0 =解剖易见，1 =解剖不易见）为评分标准（共0 - 6分）。通过非参数、生存和Cox比例风险模型分析相关性。结果133例（28.0%）患者在接受鼻窦CT扫描后平均（最小-最大）为3.2年（0-12）。在408例接受基线ESS的患者中，术前高SR或LM评分显著预测改良ESS (p <；0.001)和随访期间购买的经口皮质类固醇疗程(p = 0.009和p <；SR和lm得分分别为0.001)。在多变量分析中，SR评分、哮喘和/或非甾体抗炎药加重呼吸系统疾病（N-ERD）与改版ESS风险显著相关（p = 0.035, p = 0.007）。结论LM、SR、哮喘史或N-ERD可预测CRS复发，有助于临床决策。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.