Abstract
The purpose of this study is to evaluate lower airway hyperresponsiveness in chronic sinusitis patients with nasal polyps before and after nasal surgery (nasal polypectomy and endonasal sinus surgery), and to assess the effect of inhalation of methacholine through nose on the hyperresponsiveness of the lower airway.
The subjects were 14 males and 8 females. The age of the subjects ranged between 25 and 67 years, with an average age of 48 years.
A methacholine test through nose was performed with Astograph. The lower respiratory tract hyperresponsiveness was determined based on the respiratory resistance through the mouth, flow-volume curve and expiratory spirogram during the maximum forced vital capacity maneuver before and after methacholine inhalation through the nose. Data were obtained from 22 patients and the measurements were carried out in the follow-up period, before and after nasal surgery repeatedly.
Results :
1) The forced expiratory volume in one second percent (FEV1.0%) was suitable for assessing the level of lower respiratory tract hyperresponsiveness in these cases.
2) In the methacholine-positive group (testing positive for methacholine before nasal surgery), the lower respiratory tract hyperresponsiveness increased significantly 12 months after surgery.
3) In the methacholine-positive group, the lower respiratory tract hyperresponsiveness decreased most 18 months after surgery.
4) In the methacholine-negative group (testing negative for methacholine before nasal surgery), a marked decrease in FEV1.0% was demonstrated by methacholine inhalation 12 months after surgery.
As a result, the period necessary for treatment after nasal surgery was considered to be approximately 18 months.
