Correlation between Nasal Nitric Oxide and Quality-of-Life Improvements after Sinus Surgery

Abstract

Objectives:

Analyze the correlation between preoperative nasal nitric oxide (nNO) level, its postoperative change, and symptom scores in patients with chronic rhinosinusitis (CRS).

Methods:

We collected pre- and postoperative 3 and 6 months nNO level for patients who received bilateral endoscopic sinus surgery. They were classified according to existence of nasal polyps (NPs) and allergy test. Subjective symptoms were provided as Sino-Nasal Outcome Test-22 (SNOT-22) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Associated medical parameters were analyzed.

Results:

Fifty-four patients completed the follow-up, including 16 CRS without NPs (CRSsNPs) and 38 CRS with NPs (CRSwNPs). Allergic patients had higher preoperative nNO level (P = .042), but existence of NPs didn’t make any difference. The nNO level correlated well with computed tomography score (P = .001), endoscopy score (P < .001), and current smoking (P = .038). Baseline nNO correlated with postoperative 3-month improvement in nose blowing (P = .029) and nasal discharge (P = .007) in CRSwNPs. In nonallergic patients, higher baseline nNO had better improvement in olfaction (P = .039) and nasal discharge (P = .035). Postoperative 3 month nNO change had significant correlation with improvement of olfaction only in CRSwNPs (P = .036). The nNO change in postoperative 6 month had no correlation with any individual symptom score change in either group.

Conclusions:

Baseline nNO was significantly correlated to some of the symptom improvements in CRSwNPs and nonallergic group within 3 months postoperatively. Postoperative 3 month nNO change related to olfaction improvement in CRSwNPs group; however, no significant correlation could be detected in the 6-month period after surgery.