Computed tomography evaluation of paranasal sinuses in asthma: Is there a tendency of particular site involvement?

Although the precise mechanism is unclear, asthma and chronic sinusitis are associated frequently. Computed tomography (CT) is a sensitive modality for documenting sinonasal mucosal abnormalities. The aim of this study was to evaluate paranasal mucosal abnormalities in asthma and whether there was a relationship with asthma severity. One hundred fifty-five patients with asthma and 36 normal control subjects were assessed with coronal sinus CT. Asthma was classified as mild, moderate, or severe. Scoring of paranasal sinus abnormalities were assessed for total sinus, total mucosal, and individual sites. The mean scores of total mucosal changes (8.45 points versus 4.67 points, p < 0.001) and total sinus scores (5.50 versus 2.69, p < 0.005) were significantly higher in the asthmatic patients compared with controls. Nasal passage and frontal sinus involvements were not statistically different between groups, but all other individual scores were significantly higher in asthmatic patients. There was an involvement site tendency with respect to increasing severity of asthma. Mean total mucosal CT scores (12.57 points versus 7.33 points, p < 0.05) and individual site scores were statistically higher in asthmatic patients with high blood eosinophil levels compared with those patients with normal blood eosinophil counts except for nasal passage disease. There was no significant relationship between total IgE level and CT scores. Total mucosal and sinus scores were significantly related with asthma severity. There was an involvement tendency of sinuses and sites. Nasal passage involvement was unrelated with asthma. Ethmoidal sinuses and ostiomeatal complexes were involved significantly in patients with mild asthma, whereas maxillary, frontal, and sphenoidal sinuses were involved significantly in patients with severe asthma.