“Most people know someone who has asthma,” he said. “In those individuals, the body produces inflammation in the lining of the lungs, and that leads to wheezing and chest tightening and shortness of breath. In some people, the body produces inflammation in the lining of the sinuses. It’s not fatal like asthma, but chronic rhinosinusitis leads to a dramatic decrease in the quality of life. They are miserable.”
There are four main symptoms of CRS — nasal obstruction, nasal drainage, facial pain or pressure and decreased sense of smell. Patients need to have two out of four of these symptoms for at least 12 weeks to be diagnosed with CRS.
“The hope is with the consistent use of these nasal irrigations and corticosteroid sprays, we can keep symptoms at an acceptable level and so symptoms don’t affect patients’ quality of life,” said Sedaghat.
Sedaghat said researchers initially believed that individuals who came into the study with more severe CRS symptoms would need more antibiotics or steroids. “What we found is that is not the case,” he said. “What we found is the usage of antibiotics and steroids and the acute exacerbations is independent of baseline symptomlogy.”
“How bad you are on a day-to-day basis, that behavior of the disease, is very different than the frequency of you getting exacerbations in symptoms. These spikes in symptoms are coming from somewhere else,” said Sedaghat. “If physicians are not savvy to this, you may see someone with low-level symptoms and think the patient will be fine and believe treatment shouldn’t be as rigorous. In those patients, we found exacerbations of symptoms.”
“The frequency you needed antibiotics before the study is predictive of the frequency you need antibiotics at the end of the study,” said Sedaghat. “If you needed more antibiotics when you first started, then you will need antibiotics during the study period even if the frequency of exacerbations decreased.”
Other study co-authors include Lloyd Hoehle, Dr. David Caradonna and Dr. Stacey Gray, all three from Harvard Medical School in Boston; Dr. Marlene Speth from Kantonsspital Aarau in Aarau Switzerland; and Dr. Katie Phillips from Stanford University. No conflicts of interest were reported with this study.