Background: An association between bronchial asthma and sinusitis has long been suspected. Our aim is to study the clinical features of chronic sinusitis associated with bronchial asthma as two manifestations of one airway disease. Methods: We conducted a prospective analysis of the outcome of 88 patients, with or without bronchial asthma, who underwent endoscopic sinus surgery (ESS) for chronic sinusitis. Patients were divided into two groups by the presence or absence of asthma and were evaluated. One surgeon performed the ESS, and the same postoperative treatment was given to both groups. The postoperative outcomes of symptoms and objective findings related to sinusitis were evaluated numerically, with a maximum score of 2 points for each examination item. Twenty-eight patients with asthma symptoms were assessed before and after surgery, using peak flow (liter/second) and medication scores (according to US Food and Drug Administration) to determine whether bronchial asthma was improved by first-time ESS. Results: The outcomes of ESS were signifi- cantly worse in the asthma group, especially the endonasal findings. Patients suffering from chronic sinusitis and bronchial asthma showed improvement following ESS in terms of their asthma symptoms, peak flow and medication score. Patients with a good ESS result tended to have the greatest improvement in their asthma. Conclusions: We conclude that sinusitis and asthma are closely related to each other, acting as two manifestations of one airway disease. We recommend treating cases of sinusitis complicated by asthma as a single disease of the entire respiratory tract.

Schwartz HJ, Thompson JS, Sher TH, Ross RJ: Occult sinus abnormalities in the asthmatic patient. Arch Intern Med 1987;147:2194–2196.
Guerra S, Sherrill DL, Martinez FD, Barbee RA: Rhinitis as an independent risk factor for adult-onset asthma. J Allergy Clin Immunol 2002;109:419–425.
Gottlieb MJ: Relation of intranasal disease in the production of bronchial asthma. JAMA 1925;95:105–109.
Bullen SS: Incidence of asthma in 400 cases of chronic sinusitis. J Allergy 1932;4:402–407.
Braunstahl GJ, Fokkens W: Nasal involvement in allergic asthma. Allergy 2003;58:1235–1243.
Virant FS: Sinusitis and asthma: associated airway diseases. Curr Allergy Asthma Rep 2001;1:277–281.
Kennedy DW, Zinreich J, Rosenbaum AE, et al: Functional endoscopic sinus surgery, theory and diagnostic evaluation. Arch Otolaryngol 1985;111:576–582.
Kennedy DW: Functional endoscopic sinus surgery, technique. Arch Otolaryngol 1985;111:643–649.
Stammberger H: Endoscopic sinus surgery – Concepts in treatment of recurring rhinosinusitis. 1. Anatomic and pathophysiologic considerations. 2. Surgical technique. Otolaryngol Head Neck Surg 1986;94:143–156.
Togias A: Rhinitis and asthma: evidence for respiratory system integration. J Allergy Clin Immunol 2003;111:1171–1183; quiz 1184.
Kennedy DW: Prognostic factors, outcomes and staging in ethmoid sinus surgery. Laryngoscope 1992;102:1–18.
Gaskins RE: A surgical staging system for chronic sinusitis. Am J Rhinol 1992;6:5–12.
Marks SC, Shamsa F: Evaluation of prognostic factors in endoscopic sinus surgery. Am J Rhinol 1997;11:187–191.
Chambers DW, Davis WE, Cook PR, Nishioka GJ, Rudman DT: Long-term outcome analysis of functional endoscopic sinus surgery: correlation of symptoms with endoscopic examination findings and potential prognostic variables. Laryngoscope 1997;107:504–510.
Mehanna H, Mills J, Kelly B, McGarry GW: Benefit from endoscopic sinus surgery. Clin Otolaryngol Allied Sci 2002;27:464–471.
Schaitkin B, May M, Shapiro A, Fucci M, Mester SJ: Endoscopic sinus surgery: 4-year follow-up on the first 100 patients. Laryngoscope 1993;103:1117–1120.
Dinis PB, Gomes A: Sinusitis and asthma: how do they interrelate in sinus surgery? Am J Rhinol 1997;11:421–428.
Schapowal AG, Simon HU, Schmitz-Schumann MS: Phenomenology, pathogenesis, diagnosis and treatment of aspirin-sensitive rhinosinusitis. Acta Otorhinolaryngol Belg 1995;49:235–250.
Amar YG, Frenkiel S, Sobol SE: Outcome analysis of endoscopic sinus surgery for chronic sinusitis in patients having Samter’s triad. J Otolaryngol 2000;29:7–12.
Lund VJ, Holmstorm M, Scadding GK: Functional endoscopic sinus surgery in the management of chronic rhinosinusitis. An objective assessment. J Laryngol Otol 1991;105:832–835.
Nishioka GJ, Cook PR, Davis WE, et al: Functional endoscopic sinus surgery in patients with chronic sinusitis and asthma. Otolaryngol Head Neck Surg 1994;110:494–500.
Senior BA, Kennedy DW, Tanabodee J, et al: Long-term impact of functional endoscopic sinus surgery on asthma. Otolaryngol Head Neck Surg 1999;121:66–68.
Goldstein MF, Grundfast SK, Dunsky EH, et al: Effect of functional endoscopic sinus surgery on bronchial asthma outcomes. Arch Otolaryngol Head Neck Surg 1999;125:314–319.
Uri N, Cohen-Kerem R, Barzilai G, et al: Functional endoscopic sinus surgery in the treatment of massive polyposis in asthmatic patients. J Laryngol Otol 2002;116:185–189.
Dhong HJ, Jung YS, Chung SK, et al: Effect of endoscopic sinus surgery on asthmatic patients with chronic rhinosinusitis. Otolaryngol Head Neck Surg 2001;124:99–104.
Manning SC, Wasserman RL, Silver R, et al: Results of endoscopic sinus surgery in pediatric patients with chronic sinusitis and asthma. Arch Otolaryngol Head Neck Surg 1994;120:1142–1145.
Ikeda K, Tanno N, Tamura G, et al: Endoscopic sinus surgery improves pulmonary function in patients with asthma associated with chronic sinusitis. Ann Otol Rhinol Laryngol 1999;108:355–359.
Batra PS, Kern RC, Tripathi A, et al: Outcome analysis of endoscopic sinus surgery in patients with nasal polyps and asthma. Laryngoscope 2003;113:1702–1706.
Higashi N, Taniguchi M, Mita H, Kawagishi Y, Ishii T, Higashi A, Osame M, Akiyama K: Clinical features of asthmatic patients with increased urinary leukotriene E4 excretion (hyperleukotrienuria): involvement of chronic hyperplastic rhinosinusitis with nasal polyposis. J Allergy Clin Immunol 2004;113:277–283.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.