238 Effectiveness of Sinus Surgery for Lower Airway Disease

BACKGROUND: Upper respiratory illness can adversely impact the lower airway. This study aimed to evaluate the relationship between clinical background and improvement in the lower airway after surgery for treatment of chronic rhinosinusitis. METHODS: A total of 22 patients with chronic rhinosinusitis surgically treated between January 2010 and February 2011 were included in the study. The presence or absence of asthma and peripheral blood eosinophils count were examined for all patients in addition to preoperative radioallergosorbent tests. Spirometry was conducted and fractional exhaled nitric oxide (NO) was measured at the preoperative, 1-month postoperative, and 3-month postoperative visits. RESULTS: The average level of NO in the exhaled air at the preoperative, 1-month postoperative, and 3-month postoperative visits was 51.5 ppb, 42.5 ppb, and 38.0 ppb, respectively. Although the average results of spirometry didn't show any improvement, forced expiratory volume in 1 second percentage improved in 2 of 4 cases with obstructive ventilatory disturbance. There were 10 improved cases, which were defined as those showing more than 1.2-fold difference in the ratio of preoperative NO level to the 3-month postoperative one. The remaining 12 cases, including 4 of 6 cases with asthma, 5 of 7cases with eosinophilia, and 4 of 4 cases with animal dander allergy were unimproved cases. CONCLUSIONS: Chronic rhinosinusitis can cause latent lower respiratory disease. Endoscopic sinus surgery can improve the status of the lower airway. However, the effectiveness of surgery is significantly less in cases of animal dander allergy.