한국인에서 중심구획 아토피성 질환의 임상적 및 영상학적 특성

초록

Background and Objectives Central compartment atopic disease (CCAD) has been stud-ied with increasingly more importance as a distinct subtype of chronic rhinosinusitis with na-sal polyp (CRSwNP). Studies have shown that CCAD in Western populations show a strongassociation with allergy and typical features of medial nasal structure and sinus involvement. The purpose of this study was to evaluate the clinical characteristics of CCAD and comparethem to those of other subtypes of CRS in Korea. Subjects and Method A chart review was performed retrospectively at two tertiary rhino-logic centers for patients who were treated with bilateral endoscopic sinus surgery for CRSwith or without nasal polyp from January 2019 to December 2021. Patients were divided intothree groups, namely CCAD, CRSwNP, and CRS without nasal polyps (CRSsNP), and demo-graphics, clinical characteristics, and imaging data were compared among the three groups. Results A total of 150 patients were included in this study (50 patients in each group). CCAD showed similar nasal symptoms with CRSwNP, but higher rates of olfactory impair-ment than CRSsNP did. Allergy prevalence, serum total immunoglobulin E, and serum eo-sinophil were significantly higher in CCAD than in CRSwNP or CRSsNP. In CT scans of pa-ranasal sinuses, CCAD showed significantly less haziness of maxillary sinus and higherethmoid/maxillary score ratio than the other two groups. In addition, CT scans showed muco-sal involvements of central compartment in CCAD. Conclusion CCAD has characteristic endoscopic and imaging findings, showing a highprevalence of allergy and a strong association with the markers of type 2 inf lammation. Therefore, CCAD is a distinct disease of CRSwNP and its allergic etiology should be consid-ered in the management of patients with CCAD phenotype.

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