The Effect of Atopy on the Incidence of Osteitis in Patients with Chronic Rhinosinusitis.

Background: Atopy may not contribute directly to the pathogenesis of chronic rhinosinusitis (CRS) and could be a coexisting disease, but it may play a disease-modifying role in CRS. The aim of this study was to determine the effect of atopy on the incidence of osteitis in patients with CRS.

Methods: A cross-sectional study at a tertiary center was conducted. Computed tomography of paranasal sinuses (CTPNS) of 75 CRS patients was analyzed. Skin prick test was used to determine the atopy among the CRS patients. The evaluation consisted of symptom score, Lund-Kennedy endoscopic score and CTPNS assessment by Lund Mackay (LM) staging system and Global Osteitis Scoring Scale (GOSS).

Results: About 54.7% of CRS patients had atopy (n=41), and 64% (n=48) had osteitis changes. No significant difference (>0.05) was found for symptom and endoscopic scores in atopic and non-atopic CRS. Atopic and non-atopic CRS patients demonstrated comparable LM and GOSS scores (both >0.05). Logistic regression analysis revealed that gender, nasal polyps and bronchial asthma were significantly associated with the incidence of osteitis. Significant correlation was found between LM and GOSS scores in atopic CRS (r=0.81, <0.05). Correspondingly, both scores were found to be significantly correlated in non-atopic CRS (r=0.74, <0.05).

Conclusion: Atopic sensitization has no effect on the incidence and severity of osteitis in patients with CRS. The present study suggests that osteitis occurs independently from the atopic pathway.