Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology

Publication date: Available online 19 December 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Dirk Dietz de Loos, Evelijn S. Lourijsen, Maarten A.M. Wildeman, Nicole .J.M. Freling, Marije D.J. Wolvers, Sietze Reitsma, Wytske J. Fokkens

Abstract

Background

The prevalence of Chronic Rhinosinusitis (CRS) measured in epidemiological studies is 5-12%. This might be an overestimation because of overlap with other diseases like allergic rhinitis.

Objective

We aimed to calculate the prevalence of CRS using a combination of epidemiologically based CRS according to EPOS (European Position Paper on Rhinosinusitis and Nasal Polyps) together with sino-nasal opacification on imaging.

Methods

Subjects who underwent a CT or MRI scan of the head for any non-rhinologic indication were asked to fill in the GA2LEN survey containing the EPOS symptom criteria. The scans were evaluated according to the Lund-Mackay (LM) scoring system. Epidemiologically based CRS is based on nasal symptoms according to EPOS, clinically based CRS also encompasses endoscopy and/or CT scan.

Results

834 subjects were included. 107 subjects (12,8%) had epidemiologically based CRS according to EPOS. Of these subjects 50 % had a LM score of 0; 26% had a LM score of 1-3 and 23% had a LM score of ≥4. Twenty-five subjects (3.0%) had clinically based CRS (based on LM ≥4) and 53 subjects (6.4%) had clinically based CRS (based on LM >0). AR was reported by 167 subjects (20%). In subjects that did not report upper airway symptoms: 57% had a LM 0: 30% had a LM 1-3 and 12% had a LM ≥4. Conclusion: We found a prevalence of 3.0 – 6.4% of clinically based CRS (depending on LM cut-off point, LM≥4 or LM>0 respectively) in a relatively randomly selected group of subjects.

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