TY - JOUR
T1 - Subjective and Objective Measurements of Sinonasal Manifestations in Patients With Autoimmune Disorders
AU - Makary, Chadi A.
AU - Gill, Brittany
AU - Parman, Brock
AU - Unsal, Aykut A.
AU - Holmes, Thomas
AU - Reyes-Gelves, Camilo
AU - Kountakis, Stilianos E.
N1 - Publisher Copyright:
© 2020 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2021/2
Y1 - 2021/2
N2 - Objectives/Hypothesis: A number of autoimmune disorders (ADs) are associated with a spectrum of sinonasal manifestations comparable to chronic rhinosinusitis (CRS). Our objective was to study the subjective and objective measurements of sinonasal manifestations of ADs. Study Design: Retrospective cohort study. Methods: All patients with ADs referred to our tertiary care rhinology clinic from 2008 to 2019 with sinonasal symptoms were compared to randomly selected cohorts of noneosinophilic CRS without nasal polyps (neCRSsNP) and eosinophilic CRSsNP (eCRSsNP). Demographic data, along with the 22-item Sino-Nasal Outcome Test (SNOT-22), Lund-Kennedy (LK) endoscopy score, Lund-Mackay (LM) computed tomography (CT) score, nasal crusting, and epistaxis were reviewed at presentation. Results: Fifty-three patients with an AD (26 with sarcoidosis, 14 with systemic lupus erythematosus, 10 with granulomatosis with polyangiitis [GPA], and three with pemphigoid vulgaris) were identified, and compared to 75 randomly selected neCRSsNP patients and 75 eCRSsNP patients. Patients with an AD had an average SNOT-22 score of 44.4 (confidence interval [CI]: 34.6-51.2) compared to 25 (CI: 24.4-25.1) and 29.7 (CI: 20.3-29.7) for neCRSsNP and eCRSsNP patients, respectively (P <.0001), and an average LK endoscopy score of 5.3 (CI: 4.3-6.3), compared to 3.4 (P =.005, CI: 2.7-4) in neCRSsNP and 4.4 in eCRSsNP (P =.2, CI: 3.7-5). There was no significant difference in the CT score compared to both groups. Patients with an AD also scored significantly worse on all four SNOT-33 subdomains, nasal obstruction, nasal crusting, and epistaxis. Additionally, patients with GPA had the worst symptomatic and endoscopy scores. Conclusions: Patients with ADs presenting with sinonasal symptoms have a more severe subjective and objective presentation than patients with CRS without nasal polyps. Level of Evidence: 4 Laryngoscope, 131:255–259, 2021.
AB - Objectives/Hypothesis: A number of autoimmune disorders (ADs) are associated with a spectrum of sinonasal manifestations comparable to chronic rhinosinusitis (CRS). Our objective was to study the subjective and objective measurements of sinonasal manifestations of ADs. Study Design: Retrospective cohort study. Methods: All patients with ADs referred to our tertiary care rhinology clinic from 2008 to 2019 with sinonasal symptoms were compared to randomly selected cohorts of noneosinophilic CRS without nasal polyps (neCRSsNP) and eosinophilic CRSsNP (eCRSsNP). Demographic data, along with the 22-item Sino-Nasal Outcome Test (SNOT-22), Lund-Kennedy (LK) endoscopy score, Lund-Mackay (LM) computed tomography (CT) score, nasal crusting, and epistaxis were reviewed at presentation. Results: Fifty-three patients with an AD (26 with sarcoidosis, 14 with systemic lupus erythematosus, 10 with granulomatosis with polyangiitis [GPA], and three with pemphigoid vulgaris) were identified, and compared to 75 randomly selected neCRSsNP patients and 75 eCRSsNP patients. Patients with an AD had an average SNOT-22 score of 44.4 (confidence interval [CI]: 34.6-51.2) compared to 25 (CI: 24.4-25.1) and 29.7 (CI: 20.3-29.7) for neCRSsNP and eCRSsNP patients, respectively (P <.0001), and an average LK endoscopy score of 5.3 (CI: 4.3-6.3), compared to 3.4 (P =.005, CI: 2.7-4) in neCRSsNP and 4.4 in eCRSsNP (P =.2, CI: 3.7-5). There was no significant difference in the CT score compared to both groups. Patients with an AD also scored significantly worse on all four SNOT-33 subdomains, nasal obstruction, nasal crusting, and epistaxis. Additionally, patients with GPA had the worst symptomatic and endoscopy scores. Conclusions: Patients with ADs presenting with sinonasal symptoms have a more severe subjective and objective presentation than patients with CRS without nasal polyps. Level of Evidence: 4 Laryngoscope, 131:255–259, 2021.
KW - Chronic rhinosinusitis
KW - autoimmune disorders
KW - objective
KW - presentation
KW - subjective
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U2 - 10.1002/lary.28693
DO - 10.1002/lary.28693
M3 - Article
C2 - 32324298
AN - SCOPUS:85084058479
SN - 0023-852X
VL - 131
SP - 255
EP - 259
JO - Laryngoscope
JF - Laryngoscope
IS - 2
ER -