Clinical feature‐based diagnosis criteria of eosinophil and non‐eosinophil chronic rhinosinusitis in Taiwan

Abstract

Abstract Background The prevalence of eosinophilic chronic rhinosinusitis (ECRS) has increased in Taiwan with a higher recurrence rate of nasal polyps after surgery. Therefore, we aimed to formulate the pre‐operative diagnostic criteria for patients with ECRS in Taiwan. Methods This case–control study included patients diagnosed with CRS with nasal polyps (CRSwNP) who underwent functional endoscopic sinus surgery (FESS) at a tertiary hospital in Taiwan. The patients were classified into ECRS and non‐eosinophilic CRS (NECRS) groups based on their histopathology. Demographic data, symptom severity scores, and computed tomography findings of the two groups were analyzed. We utilized receiver operating characteristic curve (ROC) analysis to evaluate parameters that could predict the diagnosis of ECRS. Results Total 408 CRSwNP patients were enrolled (ECRS group: 163; NECRS group: 245). ECRS group was strongly associated with asthma (6.1% vs. 2.0%, p = .03), higher blood eosinophil counts (4.3% vs. 2.7%, p 45, 2 points), serum eosinophil count percentage (>4%, 4 points), asthma (4 points), total serum IgE (>140 IU/mL, 4 points), Lund–Mackay score (>9.5, 4 points), and ethmoid‐to‐maxillary opacification ratio on CT (>1.5, 5 points). The cutoff score was 14 points (sensitivity, 70.2%; specificity, 93.3%). Conclusions Clinical‐feature‐based criteria may predict the diagnosis of ECRS before FESS in Taiwan. Level of Evidence Level 3.

Keywords

• chronic rhinosinusitis
• eosinophil
• nasal polyps
• non‐eosinophil