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lateral disease, allergic fungal sinusitis was significantly higher than the control group and all the other CRS sub- classes ( P < .01). Because the two QoL questionnaires in the study were not validated in the pediatric population, and the majority of the CF patients were pediatric, CF was not included in the analysis for the QoL questionnaires. For the total CSS score, AERD was the only CRS subclass that was statistically different than the control group ( P < .05). When CSS was broken into duration and symp- tom score, CSS symptom score was significantly higher in aspirin triad and AScA than the control group ( P < .01). For the RSDI score, there was no difference between the control group and any of the CRS subclasses. There was also no statistical difference between the control group and all of the CRS subclasses combined. Even when RSDI was divided into its different components, there was no statistical difference found between the control group and any of the CRS subclasses. When evaluating all of the CRS patients, the cor- relation coefficient between RSDI to CSS was r s 5 0.52 ( P < .01). Correlation of CT to NE was r s 5 0.4 ( P < .01). Correlations of CSS to CT and NE were r s 5 0.28 and r s 5 0.38 ( P < .05), respectively. Correlation of RSDI to CT and NE were r s 5 0.32 and r s 5 0.34 ( P < .05), respectively. Histopathology and Immunostaining The eosinophil ratios were significantly higher for AFS, AERD, and AScA than both the control group and CF ( P < .05) (Table IV). Aspirin triad and AScA had higher eosinophil ratios than each nonasthmatic sinusi- tis ( P < .05) among the CRS subclasses. For PMN analysis, CF had the highest ratio of PMN and was significantly higher than the control group, NASsA, and AScA ( P < .05). There were no other significant differences. For the plasma analysis, cystic fibrosis had the highest plasma cell count. Cystic fibrosis, AFS, ASsA,

TABLE III. The Average Objective and Subjective Measurement Tools for CRS.

CRS Subclass

NE

CT Score

CSS

RDSI

AERD

2.6

14.7

16.5

10.7

AFS

2.4 2.1

13.8 14.3

9.9

8.1

CF

AScA

2.7

14

15.9

11.2

ASsA

2

12.5 10.2

13.3

18.3

NAScA

2.2

9.1

8.7

NASsA

1.4

9.3

7.4

8.3

Control

0.2 1.9

1.5

5.3

5.7 9.2

Total

10.5

10.7

and ASsA) compared to nonasthmatic sinusitis (NAScA and NASsA) ( P < .01). Asthmatic sinusitis versus 50/50 gender split had a P value of .03 in favor of more females. The results of the average nasal endoscopy, CT scores, CSS, and RSDI are listed in Table III. For the nasal endoscopy score, all of the CRS subclasses were significantly higher than the control group ( P < .01). The nasal endoscopy score for AFS, AERD, and AScA was significantly higher than NASsA ( P < .01). Aspirin triad, both AScA and ASsA, and NAScA ( P < .05) had signifi- cantly more polyps on nasal endoscopy than the control group. Cystic fibrosis ( P 5 .08) and NASsA ( P 5 .07) was trending toward significance for the presence of puru- lence, but did not reach statistical significance when compared to control group. For the CT scores, all of the CRS subclasses were significantly higher than the control group ( P < .01). Aspi- rin triad, AFS, CF, and AScA had higher CT scores than NASsA ( P < .05). When CT scores were evaluated for uni- AERD 5 aspirin exacerbated respiratory disease also known as aspirin triad; AFS 5 allergic fungal sinusitis; AScA 5 asthmatic sinusitis with allergy; ASsA 5 asthmatic sinusitis without allergy; CF 5 cystic fibrosis; CRS 5 chronic rhinosinusitis; CSS 5 chronic sinusitis survey; CT 5 computed tomography; NAScA 5 nonasthmatic sinusitis with allergy; NASsA 5 nonasthmatic sinusitis without allergy; NE 5 nasal endoscopy; RSDI 5 rhinosinusitis disability index.

TABLE IV. The Average Ratio of Cells.

CRS Subclass

Eosinophil

PMN

Plasma

Lymphocyte

Mast

Cellularity

Goblet

AERD

0.44

0.03

0.14

0.39

92

150

45

AFS

0.35

0.03

0.3

0.31

101

141

19

CF

0.004

0.06 0.01

0.45 0.17

0.47 0.32

163

96

8

AScA

0.44

85

138

80

ASsA

0.17

0.04

0.35

0.44

63

130

43

NAScA

0.17 0.08

0.02 0.01

0.26 0.32

0.45 0.49

133

109

53 89

NASsA

64

39

Control

0.02

0.03

0.17

0.76

32

18

60

Total

0.23

0.02

0.25

0.44

92

104

55

AERD 5 aspirin exacerbated respiratory disease also known as aspirin triad; AFS 5 allergic fungal sinusitis; AScA 5 asthmatic sinusitis with allergy; ASsA- asthmatic sinusitis without allergy; CF 5 cystic fibrosis; CRS 5 chronic rhinosinusitis; NAScA 5 nonasthmatic sinusitis with allergy; NASsA 5 nonasthmatic sinusitis without allergy; PMN 5 polymorphonuclear leukocyte.

Han: Subclassification of Chronic Sinusitis

Laryngoscope 123: March 2013

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