2.1.3 Impact of allergy on outcome of chronic rhinosinusitis treatment.
Ramadan and Hinerman(63), in a retrospective study, noted that children with AR underwent to ESS do not have a poorer outcome respect non allergic one. Nevertheless, children with AR who were on immunotherapy before surgery had an 84% success rate compared with 62% for those children with AR who were not treated (p = 0.022). Accordingly, Nathan et al.(64) using the Sinusitis Outcomes Questionnaire (SOQ), demonstrated that immunotherapy was an effective treatment for patients with sinus disease and AR in both children and adults.
About surgery outcomes, Kim et al.(65) and El Sharkawy et al.(66) observed that functional endoscopic sinus surgery in children with CRS and AR does not provide significantly different results compared to children without AR, which is similar to what has been reported in adults(67). On the contrary, in a study by Lee et al.(68), a significantly greater chance of protracted mucopurulent discharge after FESS was registered in patients with AR. The authors assumed that the inflammatory process of nasal allergy, which led to the development of CRS, probably impaired the post-operative wound healing by mucosal congestion, poor-functioning muco-ciliary clearance and recurrent sneezing that placed pressure on the denuded mucosa. An analogous conclusion was made by Wu et al.(69) who demonstrated that pediatric patients with positive aeroallergen tests had higher rates of CRS recurrence after ESS and required revision surgery.