METHOD TO PREDICT THE DEVELOPMENT OF POLYPOUS RHINOSINUSITIS IN PATIENTS WITH BRONCHIAL ASTHMA

Abstract

To develop and ground the method of predicting of polypous rhinosinusitis development, 75 patients with bronchial asthma in combination with polypous rhinosinusitis (the polypous tissue was first revealed at rhinoscopic research) and 28 patients with bronchial asthma and without polypous rhinosinusitis were examined. The results of the examination were compared with the group of 26 healthy people. Spirography, cold bronchoprovocation test with cold air isocapnic hyperventilation (CAIH), pneumothermometry were performed in all the patients. The method of predicting of polypous rhinosinusitis development in patients with bronchial asthma consists in the following: in 1 minute after CAIH the fall of the forced expiratory volume for the first second (∆FEV₁) was studied in comparison with its level taken before the test, the final temperature of the expired air was taken immediately after CAIH (Т°final). The patients with bronchial asthma without concomitant polypous rhinosinusitis and the patients of the control group did not have the dependence between Т°final and ∆FEV₁. The group of patients with polypous rhinosinusitis had a direct correlation between Т°final and the fall of ∆FEV₁ after bronchoprovocation (r=0.61, р<0.01), suggested the significant role of conditioning air disturbances in the formation of cold airway hyperresponsiveness in the patients with bronchial asthma and concomitant polypous rhinosinusitis. The prediction was done with the help of discriminant equation: D=2.73 ´ ∆FEV₁(%)+0.39 ´ Т °final(º С ), where D is a discriminant function with the boundary value equal to -54.02. If D was less than the boundary value, the development of polypous rhinosinusitis in patients with bronchial asthma was predicted. If D was equal or more than the boundary value the absence of polypous rhinosinusitis development in patients with bronchial asthma was predicted. The probability of the right prediction was 99.98%. This method allows to predict the development of polypous rhinosinusitis in patients with bronchial asthma at early stages.