Occurence and characteristics of allergic rhinitis in 195 patients with chronic rhinosinusitis

The role of allergic rhinitis as a causative immunopathological factor in chronic rhinosinusitis is controversial despite extensive investigation in the last 20 years. To further explore this relationship, we conducted a retrospective analysis of patients with chronic rhinosinusitis. A total of 938 consecutive cases between November 2012 and November 2016 were analyzed. In our study we included 195 patients referred to our university-based allergy and sinus clinic with chronic rhinosinusitis who were not previously operated. All these patients were thoroughly investigated with computed tomography scan, skin-prick testing, total and specific serum IgE measurements and nasal provocation. We recorded demographic data and scored the severity of sinus disease in computed tomography scans using the Lund Mackay Score. There were a total of 115 patients with chronic rhinosinusitis without evidence of an allergy based on a negative skin prick and serum IgE measurements and 80 patients with chronic rhinosinusitis and allergic rhinitis. There was no statistical significance in the Lund Mackay Score when comparing the two groups and the presence of asthma. The type of allergic rhinitis (seasonal, perennial, mixed) did not have a significant effect on the Lund Mackay Score. There was no statistical significance between allergic rhinitis and the presence of postoperative complications (major and minor complications). We found a statistically significant association between allergic rhinitis and the necessity of revision surgery (p = 0.0324) as well as a positive association between the presence of asthma and allergy (p = 0.0003). Allergic patients with chronic rhinosinusitis presented 7.2 years earlier to our otorhinolaryngology clinic and were 4.7 years younger at time of operation compared to those without an allergy, both values found to be statistically significant. Our results show a limited association between CRS severity and allergy status. However, in our study, patients with chronic rhinosinusitis and allergic rhinitis tended to present earlier, be operated at a younger age and have worst postoperative clinical outcomes compared to the non-allergic patients.