Symptoms in chronic rhinosinusitis with and without nasal polyps.

OBJECTIVES/HYPOTHESIS In this study we analyzed differences in symptoms scored between chronic rhinosinusitis patients with (CRSwNP) and without nasal polyps (CRSsNP). According to the European Position Paper on Rhinosinusitis and Nasal Polyps, CRSwNP and CRSsNP diagnoses are defined by clinical criteria supported with endoscopy. We wanted to know if it is possible to make an accurate distinction between patients with and without nasal polyps based on clinical impression. STUDY DESIGN Retrospective case-control study. METHODS We collected Rhinosinusitis Outcome Measure 31 (RSOM-31) questionnaires from chronic rhinosinusitis patients with and without nasal polyps and compared mean total RSOM-31 scores, mean domain scores, mean symptoms scores, and percentages of patients reporting symptoms per diagnosis based on endoscopy and computed tomography scan. RESULTS RSOM-31 questionnaires were collected from 234 patients. Although the total RSOM-31 score was similar and symptomatology considerably overlapping, patients with CRSwNP scored significantly higher and more often on nasal symptoms such as "rhinorrhea" and "decreased sense of taste or smell." Patients with CRSsNP significantly scored more often and higher on "facial pain" and "ear pain." CONCLUSIONS Although there were significant differences in scores on several symptoms, there was considerable overlap of many symptoms, and it remains difficult to distinguish between CRSwNP and CRSsNP based on clinical impression alone.