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.