Does recurrent sinusitis lead to a sinusitis remodeling of the upper airways in asthmatic children with chronic rhinitis?

BACKGROUND

There is a growing recognition that some patients with long-standing asthma may possess a component of irreversible airflow obstruction due to airway remodeling. The underlying chronic inflammation has been implicated as the cause of this process. In the upper airways, the inflammation presents itself with symptoms of chronic rhinitis, leading to recurrent sinusitis, in some patients.

OBJECTIVE

We attempted to determine if any changes that might be considered remodeling had occurred in the nasopharynx and paranasal sinuses of asthmatic children with recurrent sinusitis.

METHODS

Computerized-tomography (CT) scanning of the nasopharynx and paranasal sinuses was investigated retrospectively.

RESULTS

Sixty-six asthmatic patients with chronic rhinitis and recurrent sinusitis were analyzed in this respect. Their mean age was 7.41 +/- 2.91 years (26 female, 39 male). In 89% (n = 59) of the patients, tomography findings were abnormal. Among these subjects, sinusal-mucosal thickening was present in 75% (n = 44), and concha hypertrophy was present in 51% (n = 30). Adenoid hypertrophy was present in 20% (n = 12), and septum deviation was present in 17% (n = 10). CT findings were normal in 11% (n = 7).

CONCLUSION

In most of the asthmatic children having chronic rhinitis and recurrent sinusitis, the upper respiratory tract underwent a series of changes, which might be assessed as remodeling. Thus, tomography of the upper-respiratory tract may provide some useful information about the state of the disease, and to what extent the treatment can relieve symptoms of the sinus disease and the concomitant asthma.