Tobacco Smoke Relation With Chronic Sinusitis And Nasal Polips

RATIONALE: To determine if passive or active cigarette smoke exposure was found more frequently in patients who eventually developed chronic sinusitis and nasal polyps.METHODS: 170 patients with objective evidence of chronic sinusitis and nasal polyposis. The control group contained their 170 asymptomatic, age matched spouses. All of them were asked about their relation with tobacco smoke, active or passive in childhood and adulthood. Of the patient's group, 120 (70.58%) were atopic (positive wheal and flare skin test to relevant allergens) and 130 (76%) had aspirin exacerbated respiratory disease. Average age of both groups was 47 years.RESULTS: Of the 170 patients, 131 (77.0%) were exposed to passive cigarette smoke, either childhood, adulthood or both. By contrast, 69 (40.6%) of the asymptomatic controls were exposed to passive cigarette smoke, p= <0.0001. Furthermore, passive cigarette exposure was significantly longer for patients (mean 15.54 years vs 7.22 years for controls, p= <0.0001).Active smoking during adulthood was the same for patients and controls: 56 (32.9%) for patients vs. 40 (23.5%) for controls, p =NS. Only 29 (17%) of patients were not exposed to either passive or active smoking vs. 82 (48.2%) of controls, p= <0.0001.CONCLUSIONS: Passive cigarette smoke exposure is associated with inflammatory mucosal disease of the upper airways, which might result in chronic sinusitis and nasal polyps. However, cigarette smoke is unlikely to be the only provoking factor and intuitively genetic susceptibility must also be an important component in the parthenogenesis of sinusitis and nasal polyposis. RATIONALE: To determine if passive or active cigarette smoke exposure was found more frequently in patients who eventually developed chronic sinusitis and nasal polyps. METHODS: 170 patients with objective evidence of chronic sinusitis and nasal polyposis. The control group contained their 170 asymptomatic, age matched spouses. All of them were asked about their relation with tobacco smoke, active or passive in childhood and adulthood. Of the patient's group, 120 (70.58%) were atopic (positive wheal and flare skin test to relevant allergens) and 130 (76%) had aspirin exacerbated respiratory disease. Average age of both groups was 47 years. RESULTS: Of the 170 patients, 131 (77.0%) were exposed to passive cigarette smoke, either childhood, adulthood or both. By contrast, 69 (40.6%) of the asymptomatic controls were exposed to passive cigarette smoke, p= <0.0001. Furthermore, passive cigarette exposure was significantly longer for patients (mean 15.54 years vs 7.22 years for controls, p= <0.0001). Active smoking during adulthood was the same for patients and controls: 56 (32.9%) for patients vs. 40 (23.5%) for controls, p =NS. Only 29 (17%) of patients were not exposed to either passive or active smoking vs. 82 (48.2%) of controls, p= <0.0001. CONCLUSIONS: Passive cigarette smoke exposure is associated with inflammatory mucosal disease of the upper airways, which might result in chronic sinusitis and nasal polyps. However, cigarette smoke is unlikely to be the only provoking factor and intuitively genetic susceptibility must also be an important component in the parthenogenesis of sinusitis and nasal polyposis.