Chronic rhinosinusitis in a birth cohort: symptom trajectories and early-life risk factors up to young adulthood.

Background: Chronic rhinosinusitis (CRS) is common worldwide in adults, but development of CRS has rarely been studied longitudinally in birth-cohorts. The aim was to investigate development of upper airway symptoms from childhood to young adulthood and to identify early risk factors for CRS at 24 years, in a population-based birth cohort.

Method: 3037 subjects from the BAMSE (Barn/children Allergy Milieu Stockholm Epidemiology) cohort had complete question-naire answers on CRS at the 24-year-follow-up. Subjects fulfilling European Position Paper on Rhinosinusitis (EPOS) criteria of CRS at 16 and/or 24 years (n=141) were invited to a clinical examination with nasal endoscopy and interviews. Among these, 68 had clinically verified CRS symptoms. Symptoms and clinical status were compared with questionnaire-based answers on symptoms and potential risk factors for CRS, in early childhood.

Results: Among subjects with CRS symptoms at 24 years, > 60% reported upper airway symptoms already at 16 years. In the same group, a significant association was observed with a history of otitis media < 1 year and with heredity for atopic diseases. Moreover, the proportion of atopic features such as asthma, allergic rhinitis and eczema were significantly higher at 4, 8 and 16 years in this group. No clear association was found between CRS at 24 years and early RS infection, antibiotic use.