Asthma in Rhinosinusitis: A Survey from Iran

Document Type: Original


1 Sinus and Surgical Endoscopic Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran.

3 COPD Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


The coexistence of asthma and chronic rhinosinusitis (CRS) is more common than expected given their individual prevalence in the general population and may affect patient’s quality of life. The aim of this study was to evaluate the prevalence of asthma in chronic rhinosinusitis in Mashhad, Northeast Iran.
 Materials and Methods:
This study was performed in two university hospital from November 2012 for 12 months. In total, 153 patients with chronic rhinosinusitis were enrolled and referred to a particular pulmonologist for asthma evaluation.
The mean age of participants was 40.54±13.11 years, and 41.8% were male. In total, 63.4% of patients had the polypoid form of CRS. The proportion of patients in this study with asthma was 41.8%, compared with a general asthma prevalence in this region of 13.5%.
There is a high prevalence of asthma among patients with CRS, but it often remains undiagnosed. Asthma in CRS patients should be diagnosed and treated in order to improve patient’s quality of life. We recommend an evaluation of the lower airways in all of these patients as well as further studies in this field.


Main Subjects

1. Freid VM, Makuc DM, Rooks RN. Ambulatory health care visits by children: principal diagnosis and place of visit. National Center for Health Statistics. Vital Health Stat 13(137). 1998.

2. Asnaashari AMH, Talaei A, Baghban Haghighi M. Evaluation of Psychological Status in Patients with Asthma and COPD. Iran J Allergy Asthma Immunol 2012; 11:65–71.

3. Braunstahl GJ, Fokkens W. Nasal involvement in allergic asthma Allergy 2003;58:1235–43.

4. Asnaashari AMH, Rezaei S, Babaeian M, Taiarani M, Shakeri MT, Fatemi SS, et al. The effect of asthma on phonation: A controlled study of 34 patients: Ear Nose Throat J. 2012; 91:168–71.

5. Lugogo NL, Kraft M. Epidemiology of asthma: Clin Chest Med 2006,27(1):1-15

6. Krouse JH, Veling MC, Ryan MW, Pillsbury HC, Krouse HJ, Joe S, et al. Executive summary: asthma and the unified airway. Otolaryngol Head Neck Surg 2007; 136(5): 699–706.

7. Heidarnia MA, Entezari A, Moein M, Mehrabi Y, Pourpak Z. Prevalence of asthma symptom in Iran: a meta-analysis. Research in Medicine 2007; 31: 217–25.

8. Staikūniene J, Vaitkus S, Japertiene LM, Ryskiene S. Association of chronic rhinosinusitis with nasal polyps and asthma: clinical and radiological features, allergy and inflammation markers. Medicina (Kaunas). 2008; 44(4):257–65.

9. Ragab A, Clement P, Vincken W. Objective assessment of lower airway involvement in chronic rhinosinusitis. Am J Rhinol 2004;18:15–21.

10. Fan Y, Chen S, Qu X, Zuo K, Li X, Huang J, et al. A lower prevalence of asthma among patients with chronic rhinosinusitis in southern China. J Allergy Clin Immunol 2011;127:520–522.e1–5.

11. Yoshimura K, Kawata R, Haruna S, Moriyama H, Hirakawa K, Fujieda S, et al. Clinical epidemiological study of 553 patients with chronic rhinosinusitis in Japan. Allergol Int. 2011; 60: 491–6.

12. Seybt MW, McMains KC, Kountakis SE. The prevalence and effect of asthma on adults with chronic rhinosinusitis. Ear Nose Throat J. 2007; 86: 409–11.

13. Cookson JB. Prevalence rates of asthma in developing countries and their comparison with those in Europe and North America. Chest 1987; 91(6 Suppl):97S–103S.

14. Settipane GA, Chafee FH. Nasal polyps in asthma and rhinitis. A review of 6,037 patients. J Allergy Clin Immunol 1977; 59:17–21.

15. Baraniuk JN, White K. Chronic sinusitis subtypes and airway function. J Allerg Clin Immunol 2004;113:203.

16. Gu X, Ye P, Chen FY, Chen YL, Yang Y, Zhang LQ, et al. Clinical significance of pulmonary function test in patients with chronic rhinosinusitis with nasal polyps. Chinese Journal of Otorhinolaryn- gology Head and Neck Surgery 2013; 48(3):244–7.

17. Han DH, Kim SW, Cho SH, Kim DY, Lee CH, Kim SS, et al. Predictors of bronchial hyperrespon- siveness in chronic rhinosinusitis with nasal polyp Allergy 2009;64:118–22.

18. Watelet JB, Van Zele T, Brusselle G. Chronic cough in upper airway diseases. Respir Med 2010; 104: 652–7.

19.Wilkinson IA, Halliday JA, Henry RL, Hankin RG, Hensley MJ. Headache and asthma. J Paediatr Child Health 1994; 30: 253–6.

20. Lin DC, Chandra RK, Tan BK, Zirkle W, Conley DB, Grammer LC, et al. Association between severity of asthma and degree of chronic rhinosinusitis. Am J Rhinol Allergy 2011; 25: 205–8.

21. Pearlman AN, Chandra RK, Chang D, Conley DB, Tripathi-Peters A, Grammer LC, et al. Relationships between severity of chronic rhinosinusitis and nasal polyposis, asthma, and atopy. Am J Rhinol Allergy 2009; 23:145–8.

22. Tezer MS, Tahamiler R, Canakçioğlu S. Computed tomography findings in chronic rhinosinusitis patients with and without allergy. Asian Pac J Allergy Immunol 2006;24:123–7.

23. Erbek SS, Topal O, Erbek S, Cakmak O. Fungal allergy in chronic rhinosinusitis with or without polyps. Kulak Burun Bogaz Ihtis Derg 2008; 18:153–6.

24. Okayama M, Iijima H, Shimura S, Shimomura A, Ikeda K, Okayama H, et al. Methacholine bronchial hyperresponsiveness in chronic sinusitis. Respiration 1998;65:450–7.

25. Jarvis D, Newson R, Lotvall J, Hastan D, Tomassen P, Keil T et al. Asthma in adults and its association with chronic rhinosinusitis: the GA2LEN survey in Europe. Allergy 2012; 67(1): 91–8.

26. Gutman M, Torres A, Keen KJ, Houser SM. Prevalence of allergy in patients with chronic rhinosinusitis. Otolaryngol Head Neck Surg 2004; 130:545–52.

27.Rózańska-Kudelska M, Sieśiewicz A, Południewska B, Kania M, Michalczuk I, Rogowski M. Mold fungi and the role of allergy on fungi in chronic rhinosinusitis. Otolaryngol Pol 2009;63:

28. Leo G, Piacentini E, Incorvaia C, Consonni D, Frati F. Chronic rhinosinusitis and allergy. Pediatr Allergy Immunol 2007;18 Suppl 18:19–21.