University of Cincinnati (UC) researchers recently calculated what percentage of people suffering complaining about allergy symptoms actually have CRS. Their results were published in the journal Otolaryngology–Head and Neck Surgery.
“We have seen in our clinical practices many instances where patients have believed that they have allergies for many years and have sought treatment for allergies for years,” said lead author Ahmad Sedaghat, MD, PhD, of the UC College of Medicine. “They have never found relief from their sinus/nasal symptoms because all along they’ve had CRS, an inflammatory condition of the sinuses.”
The reason, according to Sedaghat, is that allergic rhinitis and CRS have overlapping symptomatology, including nasal blockage and nasal drainage.
The cross-sectional study’s chief objective was to identify predictors of CRS in patients presenting with the chief complaint of nasal allergies.
Participants came from a tertiary-care academic center. Researchers gathered clinical and demographic information from the 219 patients, nearly all of whom had a primary complaint of nasal allergies.
From all participants, results of a 22-item Sinonasal Outcome Test (SNOT-22) were collected, and a modified Lund-Kennedy endoscopy score was calculated from nasal endoscopy. The goal was to find an association between having CRS and variables of clinical and demographic characteristics, SNOT-22, and endoscopy score.
Of the patients who were recruited, 91.3% were diagnosed with allergic rhinitis, but 45.2% were also diagnosed with CRS.
Yet, the authors point out, about half of the patients with CRS reported no intranasal corticosteroid usage. They found that having CRS was associated with male sex (odds ratio [OR] = 2.29, 95% confidence interval [CI]: 1.30-4.04, P = .004); endoscopy score (OR = 1.96, 95% CI: 1.59-2.42, P <.001); and the SNOT-22 nasal subdomain score (OR = 1.07, 95% CI: 1.03-1.11, P = .001) related to SNOT-22 items: “need to blow nose,” “thick nasal discharge,” “sense of taste/smell,” and “blockage/congestion of nose.”
Results indicate that at least moderate (item score ≥3) “blockage/congestion of nose” or “thick nasal discharge,” mild “need to blow nose” (item score ≥2) or very mild decreased “sense of taste/smell” (item score ≥1), and any nasal endoscopy findings (endoscopy score ≥1) were statistically significant predictors of CRS.
“Moderate or more severe nasal obstruction or discharge symptoms, any decreased sense of smell/taste, or positive nasal endoscopy findings in patients believing they have allergic rhinitis should prompt further evaluation of CRS to avoid delays in treatment,” the researchers recommended.
“We have seen so many patients suffer for so long due to the confusion between allergies and CRS,” Dr. Sedaghat said. “I’ve had patients who tell me that they have been treated with allergy shots for 10, 20 or more years without relief of their symptoms but who after we discovered they had CRS and we started them on appropriate treatment, achieved relief within a few months.”
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