Clinical profile of chronic rhino-sinusitis

and polyposis

Abhiram Mundle
Indira Gandhi Government Medical College, Nagpur
 Introduction
CRS one of the most commonly encountered problems in

otorhinolaryngological practice

In India 134 million suffer from CRS, which is more than double the

number of diabetic patients

Nasal polyposis is considered as a subgroup of CRS- considered to

be associated with more severe forms of disease

 Aims
Various demographic features in CRS & CRS with polyposis

Clinical features in CRS & CRS with polyposis

 Methodology
Prospective study, conducted in the Dept. of ENT, IGGMC Nagpur

Cases included were of CRS with/without polyposis attending the

ENT OPD
Study population included 59-CRS, 43-CRS with polyposis

Inclusion criteria

Above 10 years of age

Diagnosed as CRS according to AAOHNS criteria

Exclusion criteria

Chronic diseases

Paranasal tumors

Pregnancy
 Methodology
A detailed history including chief complaints, associated
complaints, their onset, duration, severity and progression of
symptoms was taken

6 symptoms were taken into account associated with CRS i.e.,

nasal obstruction, nasal discharge, headache/facial pain,
postnasal discharge, sneezing and hyposmia/anosmia

Severity of symptoms was scored as per the Likert Scale(0-5)

Total Symptom Severity Score (TSSS) was calculated(0-30)

Clinical examination of nose was done

 Methodology
Subjective diagnostic criteria to be grouped into CRS and CRS with

polyposis was according to the guidelines of 12 weeks or more of

Mucopurulent drainage (anterior or posterior)

Nasal obstruction

Facial pain, pressure

Decreased sense of smell

Objective measure for the diagnosis of CRS can be documented by

Purulent (not clear) mucus or edema in the middle meatus or

ethmoid region,
and or
Polyp in the nasal cavity or the middle meatus
 Results
Age distribution

Chronic Rhinosinusitis with

Chronic Rhinosinusitis (59)
Age Group Polyposis (43)
No (%)
No (%)

10-20 16(27.3) 7(16.2)

21-30 15(25.4) 23(53.5)

31-40 2(3.4) 4(9.4)

41-50 8(13.5) 1(2.3)

51-60 14(23.7) 6(13.9)

61-70 4(6.7) 2(4.7)

Mean age in CRS group was 35.9

Mean age in CRS with polyposis group was 31.7
Sex distribution
Chronic Rhinosinusitis
Chronic Rhinosinusitis (59)
Sex with Polyposis (43)
No (%)
No (%)

Female 30(50.9) 14(32.5)

Male 29(49.1) 29(67.5)

Residence distribution
Chronic Rhinosinusitis
Chronic Rhinosinusitis (59)
Place of residence with Polyposis (43)
No (%)
No (%)

Rural 5(8.5) 18(41.9)

Urban 54(91.5) 25(58.1)

Distribution of patients according to the
nasal symptoms

Chronic Rhinosinusitis Chronic Rhinosinusitis

Symptoms
(59) n (%) with Polyposis (43) n (%)

Nasal obstruction 59(100) 43(100)

Nasal Discharge 54(91.5) 39(90.7)

Headache/Facial pain 22(37.3) 15(34.9)

Postnasal discharge 30(50.9) 23(53.5)

Sneezing 42(71.2) 31(72.1)

Anosmia 8(13.6) 29(67.4)

Clinical signs on Anterior Rhinoscopy

Chronic Rhinosinusitis with

Chronic Rhinosinusitis (59)
Clinical finding Polyposis (43)
n (%)
n (%)

DNS 40 (67.8) 28(65.1)

ITH 56 (94.9) 30(69.8)

Spur 4 (6.8) 9(20.9)

Polyp 0 (0) 40(93)

Discharge 46 (78) 43(100)

 CONCLUSIONS
Maximum number of patients having CRS were in the age group of

10-20 years i.e. 27.3 % and those with polyposis were in the age
group 21- 30 years i.e. 53.5%
Male and female were almost equal in CRS group(30:29) whereas in

polyposis group females outnumbered males(29:14).

The most common symptom was nasal obstruction (100%) followed

by nasal discharge (CRS=91.5%, CRS with polyposis=90.7%) and

then sneezing.
In this study, it was observed that the severity of symptoms was more

in the CRS with polyposis group when compared to CRS group.

Acknowledgement: Dr. Kanchan Lanjewar, Assistant Professor, ENT, IGGMC, Nagpur

Support from ICMR, New Delhi under the STS program