Author(s)
Nina Westcott
Michael Ly, Medical Student
Cameron Worden, MD
Ezer Benaim, Resident
Meghan Rebuli, PhD
Christine DeMason, MD
Charles Ebert Jr., MD, MPH, FARS
Cristine Klatt-Cromwell, MD
Ilona Jaspers, PhD
Brent Senior, MD, FARS
Adam Kimple, MD, FARS
Affiliation(s)
University of North Carolina;
Abstract:
Background: Inhalational exposures (IE) are linked to chronic rhinosinusitis (CRS). We previously demonstrated that IE burden, assessed via the Sinonasal Occupational and Airborne Pollutant Exposure (SOAPE) survey, was linked to upregulation of pro-inflammatory pathways in the sinonasal mucosa of CRS patients undergoing endoscopic sinus surgery (ESS). Here, we compare SOAPE survey scores of CRS patients with history of ESS to patients with inflammatory sinonasal disease history without ESS and to control patients with no sinonasal disease history.
Methods: Adult patients were administered the SOAPE survey in Rhinology and General Otolaryngology outpatient clinics. Vapors/mists, dusts/fibers, and smoke/fumes subgroup exposure scores and a combined SOAPE survey score were determined for each patient via a grading rubric. Extracted outcomes included history of sinonasal pathology, ESS, and asthma. A one-way ANOVA compared SOAPE survey scores across three groups and unpaired t-testing compared asthma scores.
Results: 113 patients were surveyed (45% male). Mean age was 53 years (SD 19.7). CRS surgery patients (n=49) had higher SOAPE scores (mean: 39.2, 95% CI: 30.0-48.3], compared to other sinonasal (n=36) and control (n=28) cohorts (19.1 [12.3-25.9]; 20.5 [15.0-26.0]), respectively (p<0.01). Patients with asthma history (n=50) had higher mean SOAPE scores (35.2 [27.1-43.4]) compared to non-asthma patients (n=63) (21.6 [16.2-27.5]) (p<0.01).
Discussion: Patients with CRS who underwent ESS demonstrated elevated lifetime IE exposure burden compared to those with inflammatory sinonasal disease without prior sinus surgery and controls. Patients with asthma reported higher lifetime IE exposure than patients without asthma.