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Pulmonary function tests in patients with chronic rhinosinusitis and the effect of surgery



The aims of this study were to assess the pulmonary functions in patients with chronic rhinosinusitis (CRS) in comparison with normal individuals and also to assess whether surgical correction of these patients’ condition through endoscopic sinus surgery (ESS) will result in any change in their pulmonary function tests (PFTs).

Patients and methods

A prospective study of 50 patients (group I included 25 normal individuals and group II included 25 patients who fulfilled the clinical criteria for the CRS reference) was carried out. Demographic and clinical data were obtained; spirometry was performed for all the participants studied. Postoperative spirometry was carried out for patients with CRS after 1 month of the ESS operation.


The majority of patients had a computed tomography score of 14 (11 cases). The most affected group of sinuses was the maxillary sinuses and the least affected group of sinuses was the sphenoid. There were significantly lower values of mean forced vital capacity (FVC), FVC%, forced expiratory volume in the first second (FEV1), and FEV1% in the group of patients with chronic sinusitis compared with the control healthy group. In the group of patients undergoing ESS for CRS, the mean values of FVC, FVC%, FEV1, and FEV1% were significantly higher during the postoperative follow-up period than preoperative PFTs.


PFT in patient with refractory chronic sinusitis is significantly lower than that in normal individuals and the improvement in their sinus condition can lead to an improvement in their PFT.


  1. FokkensWJ, Lund VJ,Mullol J, Bachert C, Alobid I, Baroody F, et al. AEPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. Rhinology 2012; 50:1–12.

    Article  Google Scholar 

  2. Halawi AM, Smith SS, Chandra RK. Chronic rhinosinusitis: epidemiology and cost. Allergy Asthma Proc 2013; 34:328–334.

    Article  Google Scholar 

  3. Rudmik L, Smith TL, Schlosser RJ, Hwang PH, Mace JC, Soler ZM. Productivity costs in patients with refractory chronic rhinosinusitis. Laryngoscope 2014; 124:2007–2012.

    Article  Google Scholar 

  4. Smith KA, Orlandi RR, Rudmik L. Cost of adult chronic rhinosinusitis: a systematic review. Laryngoscope 2015; 125:1547–1556.

    Article  Google Scholar 

  5. Fokkens W, Lund V, Mullol J. On behalf of the European Position Paper on Rhinosinusitis and Nasal Polyps Group. European position paper on rhinosinusitis and nasal polyps 2007. Rhinol Suppl 2007; 201–136.

  6. Strong EB, Senders CW. Surgery for severe rhinosinusitis. Clin Rev Allergy Immunol 2003; 25:165–176.

    Article  Google Scholar 

  7. Marple BF, Stankiewicz JA, Baroody FM, Chow JM, Conley DB, Corey JP, et al. Diagnosis and management of chronic rhinosinusitis in adults. Postgrad Med 2009; 121:121–139.

    Article  Google Scholar 

  8. Rosenfeld RM. Clinical practice guideline on adult sinusitis. Otolaryngol Head Neck Surg 2007; 137:365–377.

    Article  Google Scholar 

  9. Morice AH, Fontana GA, Sovijarvi AR, Pistolesi M, Chung KF,Widdicombe J, et al. The diagnosis and management of chronic cough. Eur Respir J 2004; 24:481–492.

    Article  CAS  Google Scholar 

  10. Guilemany JM, Angrill J, Alobid I, Centellas S, Pujols L, Bartra J, et al. United airways again: high prevalence of rhinosinusitis and nasal polyps in bronchiectasis. Allergy 2009; 64:790–797.

    Article  CAS  Google Scholar 

  11. Hayden FG. Rhinovirus and the lower respiratory tract. Rev Med Virol 2004; 14:17–31.

    Article  Google Scholar 

  12. Vinuya RZ. Upper airway disorders and asthma: a syndrome of airway inflammation. Ann Allergy Asthma Immunol 2002; 88:8–15.

    Article  Google Scholar 

  13. Kariya S, Okano M, Higaki T, Noyama Y, Haruna T, Ishihara H, et al. Chronic rhinosinusitis patients have decreased lung function. Int Forum Allergy Rhinol 2014; 4:828–833.

    Article  Google Scholar 

  14. Annamalai S, Davis J, Kubba H. How subjective is nasal endoscopy? A study of interrater agreement using the Lund and Mackay scoring system.Am J Rhinol 2004; 18:301–303.

  15. Lund VJ, Mackay IS. Staging in rhinosinusitis. Rhinology 1993; 31:183–184.

    CAS  PubMed  Google Scholar 

  16. Global Initiative for Asthma. Global strategy for asthma management and prevention. Baltimore, MD: Global Initiative for Asthma; 2013. http://www.

  17. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardization of spirometry. Eur Respir J 2005; 26:319–338.

    Article  CAS  Google Scholar 

  18. Stammberger H, Posawetz W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 1990; 247:63–76.

    Article  CAS  Google Scholar 

  19. Steinke JW, Payne SC, Tessier ME, Borish LO, Han JK, Borish LC. Pilot study of budesonide inhalant suspension irrigations for chronic eosinophilic sinusitis. J Allergy Clin Immunol 2009; 124:4–1.

    Article  Google Scholar 

  20. Batra PS, Kern RC, Tripathi A, Conley DB, Ditto AM, Haines GK, et al. Outcome analysis of endoscopic sinus surgery in patients with nasal polyps and asthma. Laryngoscope 2003; 2003; 13:1703–1706.

  21. Jarvis D, Newson R, Lotvall J, Hastan D, Tomassen P, Keil T, et al. Asthma in adults and its association with chronic rhinosinusitis: The GA(2) LEN survey in Europe. Allergy 2012; 67:91–98.

    Article  CAS  Google Scholar 

  22. Stelmach R, Junior SA, Figueiredo CM, Uezumi K, Genu AM, Carvalho-Pinto RM, et al. Chronic rhinosinusitis in allergic asthmatic patients: radiography versus low-dose computed tomography evaluation. J Asthma 2010; 47:599–603.

    Article  Google Scholar 

  23. Kim HY, So YK, Dhong H, Chung SK, Choi DC, Kwon NH, Oh MJ. Prevalence of lower airway diseases in patients with chronic rhinosinusitis. Acta Otolaryngol Suppl 2007; 127:110–114.

    Google Scholar 

  24. Vashishta R, Soler ZM, Nguyen S, Scholsser RJ. A systematic review and meta-analysis of asthma outcomes following endoscopic sinus surgery for chronic rhinosinusitis. Int Forum Allergy Rhinol 2013; 788–794.

  25. Chen FH, Zuo KJ, Guo YB, Li ZP, Xu G, Xu R, et al. Long-term results of endoscopic sinus surgery-oriented treatment for chronic rhinosinusitis with asthma. Laryngoscope 2014; 124:24–28.

    Article  Google Scholar 

  26. Gulati SP, Chaudhry D, Kalra V, Wadhera R, Garget A, et al. The role of functional endoscopic sinus surgery (FESS) in patients with asthma with chronic sinusitis. Indian J Otolaryngol Head Neck Surg 2008; 60:152–155.

    Article  CAS  Google Scholar 

  27. Ikeda K, Tanno N, Tamura G, Suzuki H, Oshima T, Shimomura A, et al. Endoscopic sinus surgery improves pulmonary function in patients with asthma associated with chronic sinusitis. Ann Otol Rhinol Laryngol 1999; 108:355–359.

    Article  CAS  Google Scholar 

  28. Palmer JN, Conley DB, Dong RG, Ditto AM, Yarnold PR, Kern RC. Efficacy of endoscopic sinus surgery in the management of patients with asthma and chronic sinusitis. Am J Rhinol 2001; 15:49–53.

    Article  CAS  Google Scholar 

  29. Ragab S, Scadding GK, Lund VJ, Saleh H. Treatment of chronic rhinosinusitis and its effects on asthma. Eur Respir J 2006; 28:68–74.

    Article  CAS  Google Scholar 

  30. Mohamed A, Hesham R, Sonya E. The of functional endoscopic sinus surgery on pulmonary functions of patients with asthma and chronic sinusitis. AAMJ 2013; 11:1–5.

    Google Scholar 

  31. Dhong HJ, Jung YS, Chung SK, Choi DC. Effect of endoscopic sinus surgery on asthmatic patients with chronic rhinosinusitis. Otolaryngol Head Neck Surg 2001; 124:99–104.

    Article  CAS  Google Scholar 

  32. Razmpa E, Saedi B, Safavi A. The effect of functional endoscopic sinus surgery on pulmonary improvement of controlled asthmatic patients with chronic sinusitis. Iran J Allergy Asthma Immunol 2010; 9:231–236.

    PubMed  Google Scholar 

  33. Ogunleye AO, Fasunla AJ. Radiological changes and complications associated with nasal polyposis. West Afr J Med 2004; 23:111–113.

    CAS  PubMed  Google Scholar 

  34. Matsumoto K, Kawayama T, Kinoshita T, Minami S, Matsunaga K, Nagafuchi M, et al. Chronic rhinosinusitis is associated with airflow obstruction in Japanese never-smokers without asthma. Int J Respir Pulm Med 2:0–23.

  35. Lee SY, Yoon SH, Song WJ, Lee SH, Kang HR, Kim SS, et al. Influence of chronic sinusitis and nasal polyp on the lower airway of subjects without lower airway diseases. Allergy Asthma Immunol Res 2014; 6:310–315.

    Article  Google Scholar 

  36. Togias A.Mechanisms ofnose-lung interaction. Allergy1999;57:S94–S105.

  37. Shturman-Ellstein R, Zeballos R, Buckley J, Souhrada JF. The beneficial effect of nasal breathing on exercise induced bronchoconstriction. Am Rev Respir Dis 1978; 118:65–73.

    CAS  PubMed  Google Scholar 

  38. Karuthedath S, Singh I, Chadha S. Impact of functional endoscopic sinus surgery on the pulmonary function of patients with chronic rhinosinusitis: a prospective study. Indian J Otolaryngol Head Neck Surg 2014; 66:441–448.

    Article  Google Scholar 

  39. Wood RA, Eggleston PA. The effect of intranasal steroids on nasal and pulmonary responses to cat exposure. Am J Respir Crit Care Med 1995; 151:315–320.

    Article  CAS  Google Scholar 

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Correspondence to Mohammad T. Abdel Fattah MD.

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Yousof, A.M., Awada, O.G., Abdel Fattah, M.T. et al. Pulmonary function tests in patients with chronic rhinosinusitis and the effect of surgery. Egypt J Bronchol 11, 283–287 (2017).

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