Effect of asthma on sinus computed tomography grade and symptom scores in patients undergoing revision functional endoscopic sinus surgery

Background: The aim of this study was to determine the influence of asthma on sinus computed tomography (CT) grade, endoscopic appearance, and symptom scores in patients undergoing revision functional endoscopic sinus surgery (FESS). Methods: Prospective data was collected of patients undergoing revision FESS at a tertiary medical center over a 2-year period. CT scans were graded as per the Lund and Mackay system. Patient symptom scores were recorded from the Sino-Nasal Outcome Test (SNOT 20) inventory and individual symptoms from the Rhinosinusitis Task Force major and minor symptom list were graded on a visual analog scale. Results: Eighty patients underwent revision FESS and 20 of those patients had asthma. The average CT grade in asthmatic patients was 18.6 compared with 11.7 in patients who were nonasthmatic (p = 0.000006). The average SNOT 20 symptom score in patients with asthma was 49.6 and in nonasthmatic patients it was 44.9 (p = 0.238). Both asthmatic and nonasthmatic patients experienced a reduction in SNOT 20 symptom scores at 1 year with reductions of 70% (p = 0.0000)versus 72.6% (p = 0.0000), respectively. Conclusion: Patients with asthma undergoing revision FESS had higher sinus CT grades compared with patients without asthma. Asthmatic and nonasthmatic patients had statistically significant reductions in symptoms scores after revision FESS. Asthmatic patients had similar symptomatic relief scores after revision FESS as compared with nonasthmatic patients.