Upper and lower airways associations in patients with chronic rhinosinusitis and bronchiectasis. Issue 11 (23rd July 2013)

• Record Type: Journal Article
• Authors: Ramakrishnan, Vijay R.; Ferril, Geoffrey R.; Suh, Jeffrey D.; Woodson, Trudi; Green, Tyler J.; Kingdom, Todd T.
• Is Part Of: International forum of allergy & rhinology. Volume 3:Issue 11(2013:Nov.)
• Page Start: 921
• Page End: 927
• Publication Date: 2013-07-23
• Subjects: 617.51005
• DOI: 10.1002/alr.21204
• Languages: English
• ISSNs: 2042-6976

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="alr21204-sec-0010" sec-type="section"> <title>Background</title> <p>Bronchiectasis is an uncommon disease of the lower airways characterized by bronchial wall destruction and permanent bronchiolar dilation. Several etiologic categories exist, and patients with bronchiectasis often complain of symptoms suggestive of chronic rhinosinusitis (CRS). The present study investigates the association between bronchiectasis and CRS using radiologic and bacteriologic data.</p> </sec> <sec id="alr21204-sec-0020" sec-type="section"> <title>Methods</title> <p>Retrospective chart review from a tertiary care respiratory hospital was performed. Sinus computed tomography (CT) scans were examined for extent of disease and relationship to pulmonary disease severity. Statistical analysis was performed with Student <italic>t</italic> test and linear regression. Upper and lower airway cultures from patients with both bronchiectasis and CRS were compared using the chance adjusted agreement.</p> </sec> <sec id="alr21204-sec-0030" sec-type="section"> <title>Results</title> <p>Patients with bronchiectasis were found to have a significantly higher Lund‐Mackay score when compared to patients with allergic rhinitis (<italic>p</italic> = 0.047). Lund‐Mackay CT score did not correlate with forced expiratory volume in 1 second (FEV<sub>1</sub>) and FEV<sub>1</sub>:forced vital capacity (FVC), or presence of <italic>Pseudomonas aeruginosa</italic>. Correlation of upper and lower airway bacterial cultures in patients with both bronchiectasis and CRS was noted (kappa = 0.294, <italic>p</italic> = 0.004), particularly when <italic>P. aeruginosa</italic> was present (kappa = 0.49, <italic>p</italic> < 0.0001).</p> </sec> <sec id="alr21204-sec-0040" sec-type="section"> <title>Conclusion</title> <p>The current study suggests that the upper and lower airways may be linked in CRS and bronchiectasis from both an objective radiologic standpoint and a bacteriologic perspective. This finding carries implications for disease pathogenesis, clinical care, and future research.</p> </sec> </abstract>