Author(s)
Chadi A. Makary, MD
Connor V. Hunt, BS
Melissa C. Cummins, BS
Hassan H. Ramadan, MD MSc
Affiliation(s)
West Virginia University School of Medicine;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand the impact that asthma has on the quality of life of pediatric patients with chronic rhinosinusitis. This will assist in the treatment of pediatric patients with the comorbidities.
Objectives: Few studies have evaluated the role of asthma in pediatric chronic rhinosinusitis (CRS). Asthma has been associated with an increased risk of failure of adenoidectomy for pediatric CRS. The objective of this study is to evaluate how asthma affects the quality of life (QoL) and the severity of CRS in children.
Study Design: Cross-sectional study of all pediatric patients presenting to our clinic between August 2020 and June 2024 was performed.
Methods: CRS was defined based on the presence of objective evidence of disease. QoL was measured using the Sinus and Nasal QoL (SN-5). Patients' characteristics and comorbidities were also reviewed. Children with cystic fibrosis or primary ciliary dyskinesia were excluded.
Results: A total of 124 children were included, 34 of them (27.4%) had asthma. Children with asthma were older (11.3 vs 7.4 years, p<0.001), more likely to have CRS vs chronic adenoiditis (38.6% vs 19.7%, p=0.018), and more likely to undergo functional endoscopic sinus surgery (FESS) vs adenoidectomy (45.5% vs 16.7%, p=0.021). Multivariate linear regression for SN-5 scores adjusting for age, gender, allergic rhinitis, and obstructive sleep apnea shows that asthma was significantly associated with worse QoL [Coef 0.71, 95% CI (0.23,1.19)]. The presence of asthma increases the SN-5 by 0.71, which is more than the minimal clinically important difference of 0.5.
Conclusions: In children with CRS, presence of asthma has a negative impact on the disease specific QoL. Further research is needed to evaluate how asthma affects the outcome of FESS in children.