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Nasal nitric oxide as a long‐term monitoring and prognostic biomarker of mucosal health in chronic rhinosinusitis
Author(s) -
Lee Daniel J.,
Yip Jonathan,
Lee John M.
Publication year - 2020
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.22581
Subject(s) - medicine , chronic rhinosinusitis , biomarker , cohort , gastroenterology , endoscopic sinus surgery , prospective cohort study , endoscopy , sinusitis , surgery , biochemistry , chemistry
Background Nasal nitric oxide (nNO) is a potential biomarker of chronic rhinosinusitis (CRS), and correlates well with endoscopic and radiologic severity of disease. However, the long‐term profile of nNO as a biomarker is not established in the literature. The objectives of our study were to examine whether nNO can maintain this correlation in a 5‐year follow‐up after endoscopic sinus surgery (ESS) and to investigate whether nNO value can be used to prognosticate revision rates in patients with CRS. Methods We enrolled CRS patients 5 years after initial ESS at our institution. Patients underwent initial ESS at our institution between January 2013 and January 2015. Patients prospectively had the following measurements at baseline, 1 month, 6 months, and 5 years post‐ESS: nNO levels, Lund‐Kennedy Endoscopy Score (LKES), and 22‐item Sino‐Nasal Outcome Test‐22 (SNOT‐22) score. We also compared the nNO levels between patients who underwent revision ESS and those who did not. Results There were 32 patients included in the study with 8 patients undergoing revision ESS during the 5‐year follow‐up. nNO levels were elevated at 1 month, 6 months, and 5 years post‐ESS compared to baseline. A significant negative correlation between nNO and LKES was found at 5 years post‐ESS. nNO levels were significantly reduced at baseline and 6 months post‐ESS in the revision cohort compared to the nonrevision cohort despite having comparable radiologic severity. Conclusion nNO may serve as a noninvasive long‐term biomarker to monitor sinus disease severity and to prognosticate results in patients with CRS. This has implications for potential integration into clinical practice.