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Sinus CT effectively screened airway hyperresponsiveness in chronic rhinosinusitis

Sinus CT was an effective screening tool for airway hyperresponsiveness in patients with chronic rhinosinusitis, according to recent study results.

Researchers in China conducted a prospective, single blind trial of 125 patients with chronic rhinosinusitis. Histamine provocative test results were used to divide patients into airway hyperresponsiveness (AHR; n=57; mean age, 44.61 years; 38.6% women) and non-AHR (NAHR; n=68; mean age, 40.75 years; 22.1% women) groups. The patients underwent CT in a supine position. Lund-Mackay scores, olfactory cleft scores and serum eosinophil counts were compared between the two cohorts.

Patients in the AHR group had significantly higher olfactory cleft scores, ratio of olfactory cleft scores to total scores, and eosinophil counts compared with the NAHR cohort (P<.001). Olfactory cleft scores (P<.001) and eosinophil counts (P=.01) acted as independent risk factors for asymptomatic AHR, according to multivariate logistic regression.

“The [olfactory cleft] score had a higher predictive value for AHR (area under the curve, 0.800) than eosinophil counts (area under the curve, 0.637),” the researchers wrote.

Sensitivity was 75%; specificity, 77.9%; and positive predictive value, 68.8% when the olfactory cleft score was 3 or higher.

 “[chronic rhinosinusitis] with concomitant AHR has specific features on CT,” the researchers concluded. “Bilateral [olfactory cleft] opacification is the most distinctive characteristic. [Olfactory cleft] score is a powerful tool to screen for AHR in [chronic rhinosinusitis] patients.”

Disclosure: The researchers report no relevant financial disclosures.