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Article Type

Article

Abstract

Introduction: Most patients with asthma have rhinitis and/or Sinusitis suggesting the concept of (one airway one disease). The presence of allergic rhinitis and/or Sinusitis commonly exacerbates asthma, increasing the risk of asthma attacks, emergency visits and hospitalizations for asthma. However the precise nature of their relationship is poorly understood.

Objective:  to evaluate the sino-nasal endoscopic examination and the sinus CT findings to detect the diagnosis of nasal diseases in bronchial asthma patients. Methods: A total of 100 patients with bronchial asthma attending the outpatient clinic of chest department in Bab Elsharia Al-Azhar University hospital referred to ENT outpatient clinic were evaluated in the period from January 2013- May 2014. The patients were classified into 2 groups:-
Group (A): asthmatic patients presented with nasal symptoms (72%) and Group (B): asthmatic patients without any nasal symptoms (28%). The patients were evaluated by the sino-nasal endoscopy and Sinus CT scans.

Results: The present study reveled that the most significant difference of nasal disease between the patients of Group (A) and Group (B) were: (1) Rhinosinusitis with P value (0.04), (2) CRS with Allergic sinonasal polyposis with P value (0.02) and (2) Free nasal disease patients with P value (<0.001). Other diseases showed no significant difference between patients of Group (A) and Group (B) as allergic rhinitis ± HIT, allergic rhinosinusitis ± HIT, rhinosinusitis and allergic fungal sinusitis as their P value were (> 0.05). The CT scan (score ≥12) appeared to be significantly associated with the diagnosis of (1) Allergic HIT with P value (0.03), (2) CRS with Allergic sinonasal polyposis with P value (<0.001), (3) MP discharge with P value (0.002), (4) CRS with Inflammatory polyp with P value (<0.001) and (5) free nasal endoscopic patients.

Conclusion: To improve asthma control, our data indicate that both sino-nasal endoscope and the sinus CT are a useful and practicable techniques as they play important roles in the management of asthmatic patients, because they can assess what are the situation of nose and paranasal sinuses at the time of examination which allow immediate management of both upper and lower airway simultaneously.

Keywords: CT, FESS, BA

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