Assessment of symptom severity in chronic rhinosinusitis with and without polyps- a prospective study in tertiary care centre at Mandya

Abstract

Chronic Rhinosinusitis has been classified into Chronic Rhinosinusitis with Polyps (CRSwNP) and Chronic Rhinosinusitis without Polyps (CRSsNP) in accordance with the manifestation of the chronic inflammatory process affecting the Sinonasal mucosa. Two subtypes of CRS have varied clinical and radiologic manifestations. Wide range of symptoms and their severity significanty affects the quality of living which can be systematically assessed using QOL questionnaire.

Objectives: To assess the symptoms severity using SNOT 22 questionairre in CRSwNP and CRSsNP. Using the above data, the possibility of diagnosis of presence or absence of nasal polyps by symptom analysis will be correlated

Materials and Methods: Duration of the study was two years from May 2016 to April 2018 and Convenient (purposive)sampling method was used for sampling. SNOT 22 sino nasal outcome test questionnaire, a validated tool was used to assess the patients. All these patients were evaluated according to the standard laboratory profiles of allergy. Analysis Data was entered into Microsoft Excel (Windows 7; Version 2007) and analyses were done using the Statistical Package for Social Sciences (SPSS) for Windows software (version 22.0; SPSS Inc, Chicago).

Results: While Nasal obstruction was the most important symptom, Smoking tobacco(cigarettes) was also the most important characteristic that significantly affected both groups. Headache, Facial pain and Pressure were also universally present in both groups. Seromucinous Rhinorrhoea (4.03 vs 1.79; p value 0.001), Sneezing (4.24 vs 2.35; p value 0.001), Alteration of Taste and Smell (3.64 vs 1.25; p value 0.001) were also the factors that affected the quality of life.

Conclusion: There is a considerable overlap in the presentation and no actual correlation can be made by using only symptomatology as a tool. Endoscopic and CT scan findings are the most important entities to finally differentiate these two conditions along with immunological studies.