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The association of premorbid diseases with chronic rhinosinusitis with and without polyps

Lam, Kenta; Hirsch, Annemarie G.b; Tan, Bruce K.a

Current Opinion in Otolaryngology & Head and Neck Surgery: June 2014 - Volume 22 - Issue 3 - p 231–241
doi: 10.1097/MOO.0000000000000052
ALLERGY: Edited by Sandra Y. Lin
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Purpose of review To review the recent insights regarding the epidemiology of adult chronic rhinosinusitis (CRS), with particular attention to its association with other premorbid conditions. Identifying premorbid disease associations establishes potential risk factors for developing CRS and helps corroborate current postulates of the various pathophysiologic mechanisms involved with the development and persistence of paranasal sinus inflammation.

Recent findings Recent findings demonstrate that the diagnosis of CRS is associated with a higher premorbid prevalence of upper airway diseases, lower airway diseases, gastroesophageal reflux disease, diseases of epithelial tissues, autoimmune disorders, and psychiatric conditions. Although some of these conditions have long been associated with CRS, improvements in study design and future studies in the general population will more accurately estimate the relative strengths of associations, clinical relevance, and temporal relationship of these various conditions in relation to the development of CRS.

Summary The predisposing patterns of premorbid illnesses may provide valuable information regarding the underlying causes of CRS and allow for both therapeutic and preventive interventions. There remains conflicting evidence within the literature regarding the association of CRS with some medical conditions, signifying the need for continued research on the subject. Limitations of the current studies include small sample sizes, lack of prospective longitudinal or interventional studies that help establish causality, and variable criteria for diagnosis of CRS in the outpatient setting.

aDepartment of Otolaryngology – Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois

bCenter for Health Research, Geisinger Health System, Danville, Pennsylvania, USA

Correspondence to Bruce K. Tan, MD, Department of Otolaryngology – Head and Neck Surgery, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 1325, Chicago, IL 60611, USA. Tel: +1 312 695 3222; fax: +1 312 695 3194; e-mail:

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