Application of questionnaires in the assessment of clinical severity of chronic rhinosinusitis

  • Marija Stupar University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Djordje Špreng Serbian Armed Forces, Guard, Belgrade, Serbia
  • Aleksandar Perić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Keywords: rhinitis, sinusitis, chornic disease, surveys and questionnaires, signs and symptoms, diagnosis

Abstract


Background/Aim. Diagnosis of chronic rhinosinusitis (CRS) is based on clinical symptoms, and confirmed with endoscopic findings and computed tomography (CT) scans of paranasal sinuses. However, the results of numerous studies have shown that the symptoms that patients report are not in correlation with the degree of the disease spread obtained by radiological findings. The aim of our study was to examine is there a correlation between the degree of symptoms intensity of the non-polypous and polypous form of CRS and the degree of the disease spread, obtained on the basis of radiological diagnostics. Methods. A total of 60 patients, of which 30 patients with CRS without nasal pol­yps (CRSsNP) and 30 with CRS with nasal polyps (CRSwNP), were included in this cross-sectional study. Symptoms were evaluated using two questionnaires: Sino-Nasal Outcome Test 22 (SNOT-22) and Visual Analogue Score (VAS). The Lund Mackay CT score was used as a ra­diological parameter of the disease expansion. In addition, each of the subjects was examined for sensitivity to standard inhalation allergens. Results. In patients with CRSsNP, there were statistically significant positive correlations be­tween the Lund Mackay CT score and the SNOT-22 score (r = 0.578, p = 0.001) and between the Lund Mackay CT score and the VAS (r = 0.408, p = 0.025). We found no cor­relation between the both questionnaire scores and the Lund Mackay score in CRSwNP patients. In patients with CRSwNP, a statistically significant difference was found in the values of SNOT-22 between patients with and without sensitivity to inhalation allergens, with higher values of the score in patients with allergy (p = 0.039). Conclusion. There is a positive correlation between the severity of the symptoms and the radiological findings only in patients with CRSsNP, which suggests that application of these question­naires would be possible only in the case of this clinical en­tity.

References

Fokkens W, Lund V, Mullol J. European Position Paper on Rhinosinusitis and Nasal Polyps group. European position pa-per on rhinosinusitis and nasal polyps 2007. Rhinol Suppl 2007; 20: 1–136.

Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl 2012; 23: 3 p preceding table of contents, 1–298.

Zhang N, Holtappels G, Claeys C, Huang G, van Cauwenberge P, Bachert C. Pattern of inflammation and impact of Staphylo-coccus aureus enterotoxins in nasal polyps from southern Chi-na. Am J Rhinol 2006; 20(4): 445–50.

Johansson L, Akerlund A, Holmberg K, Melen I, Bende M. Preva-lence of nasal polyps in adults: the Skovde population-based study. Ann Otol Rhinol Laryngol 2003; 112(7): 625–9.

Dietz de Loos DA, Hopkins C, Fokkens WJ. Symptoms in chronic rhinosinusitis with and without nasal polyps. Laryngo-scope 2013; 123(1): 57–63.

Durr DG, Desrosiers MY, Dassa C. Impact of rhinosinusitis in health care delivery: the Quebec experience. J Otolaryngol 2001; 30(2): 93–7.

Goetzel RZ, Hawkins K, Ozminkowski RJ, Wang S. The health and productivity cost burden of the “top 10” physical and mental health conditions affecting six large U.S. employers in 1999. J Occup Environ Med 2003; 45(1): 5–14.

Stankiewicz JA, Chow JM. Nasal endoscopy and the definition and diagnosis of chronic rhinosinusitis. Otolaryngol Head Neck Surg 2002; 126(6): 623–7.

Stankiewicz JA, Chow JM. A diagnostic dilemma for chronic rhinosinusitis: definition accuracy and validity. Am J Rhinol 2002; 16(4): 199–202.

van Oene CM., van Reij EJF., Sprangers MAG., Fokkens WJ. Quality assessment of disease-specific quality of life question-naires for rhinitis and rhinosinusitis: a systematic review. Al-lergy 2007; 62(12): 1359–70.

Morley AD, Sharp HR. A review of sinonasal outcome scoring systems: which is best? Clin Otolaryngol Allied Sci 2006; 31(2): 103–9.

Lund VJ, Mackay IS. Staging in rhinosinusitis. Rhinology 1993; 31(4): 183–4.

Toros SZ, Bölükbasi S, Naiboğlu B, Er B, Akkaynak C, Noshari H, et al. Comparative outcomes of endoscopic sinus surgery in patients with chronic sinusitis and nasal polyps. Eur Arch Otorhinolaryngol 2007; 264(9):1003-8.

Ryan WR, Ramachandra T, Hwang PH. Correlations between symptoms, nasal endoscopy, and in-office computed tomogra-phy in post-surgical chronic rhinosinusitis patients. Laryngo-scope 2011; 121(3): 674–8.

Razmpa E, Saedi B, Dostee A, Ordobadee M. Correlation of pre-operative sinusitis patients' characteristics with final diagnostic findings. Acta Med Iran 2013; 51(8): 525–9.

Basu S, Georgalas C, Kumar BN, Desai S. Correlation between symptoms and radiological findings in patients with chronic rhinosinusitis: an evaluation study using the Sinonasal Assess-ment Questionnaire and Lund-Mackay grading system. Eur Arch Otorhinolaryngol 2005; 262(9): 751–4.

Hopkins C, Browne JP, Slack R, Lund V, Brown P. The Lund-Mackay staging system for chronic rhinosinusitis: how is it used and what does it predict? Otolaryngol Head Neck Surg 2007: 137(4): 555–61.

Eweiss AZ, Lund VJ, Barlow J, Rose G. Do patients with chron-ic rhinosinusitis with nasal polyps suffer with facial pain? Rhi-nology 2013; 51(3): 231–5.

Banerji A, Piccirillo JF, Thawley SE, Levitt RG, Schechtman KB, Kramper MA et al.. Chronic rhinosinusitis patients with polyps or polypoid mucosa have a greater burden of illness. Am J Rhinol 2007; 21(1): 19–26.

Bhattacharyya N. Assessing the additional disease burden of polyps inchronic rhinosinusitis. Ann Otol Rhinol Laryngol 2009; 118(3): 185–9.

Drake-Lee AB, Lowe D, Swanston A, Grace A. Clinical profile and recurrence of nasal polyps. J Laryngol Otol 1984; 98(8): 783–93.

Stammberger H, Wolf G. Headaches and sinus disease: the en-doscopic approach. Ann Otol Rhinol Laryngol Suppl 1988; 134: 3–23.

Schor DI. Headache and facial pain- the role of the paranasal sinuses: a literature review. J Craniomandibular Pract 1993; 11(1): 36–47.

Ling FT, Kountakis SE. Important clinical symptoms in pa-tients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis. Laryngoscope 2007; 117(6): 1090–3.

West B, Jones NS. Endoscopy-negative, computed tomogra-phy-negative facial pain in a nasal clinic. Laryngoscope 2001; 111(4 Pt 1): 581–6.

Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disor-ders: 2nd edition. Cephalalgia 2004; 24 Suppl 1: 9–160.

Van Crombruggen Koen, Zhang N, Gevaert P, Tomassen P, Bachert C. Pathogenesis of chronic rhinosinusitis: Inflammation. J Al-lergy Clin Immunol 2011; 128(4): 728–32.

Published
2021/08/19
Section
Original Paper