الفهرس 
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Abstract
Summary
Chronic sinusitis is defined as an inflammatory disease of the nose and sinus mucosa which is caused by a disturbance of ventilation and nasal cavity drainage.
Blockage of ostium sinus by edema and inflammatory mucous, delayed retrieval of mucociliary function directly lead to a transition from an acute to a chronic inflammatory process.
Symptoms of chronic rhinosinusitis (CRS) include mucopurulent anterior or posterior nasal discharge, regional facial pain, sinus region tenderness, fetid odor, and other symptoms that don’t respond to 12 weeks of adequate therapy, Olfactory loss is a defining symptom of chronic rhinosinusitis and also Hypoxia, hypercapnia, snoring and sleep disorders.
The diagnosis of chronic sinusitis based only on symptom criteria is difficult because most symptoms are not specific and do not distinguish between radiographically nor¬mal and diseased patients so associated radiograph¬ic evidence is required to diagnose chronic sinusitis and addition of nasal endoscopy to symptom assessment increases diagnostic accuracy in confirming the presence of CRS.
The etiology of nasal polyps is multifactorial includes Inflammation, edema and mucosal swelling and nasal polyps (CRSwNP) appeared as bilateral pedunculated lesions endoscopically visualized.
CT scan is considered as gold standard for the radiographic delineation of sinus disease and CT finding is key component in severity staging systems for chronic sinusitis.
The unified airway concept considers the entire respiratory system to represent a functional unit that consists of the nose, paranasal sinuses, larynx, trachea, and distal lung
Chronic upper airway diseases include allergic rhinitis, non-allergic rhinitis (NAR), chronic rhinosinusitis (CRS) with or without nasal polyposis are commonly associated with asthma, and increase the complexity of management and costs
Nasal obstruction role in the development of lower airway disease includes loss of nasal function for cleaning, warming, and humidifying the inhaled air, loss of its protective mechanism and it induces a blockage of the sinus ostia with a reduction in the nitric oxide level in the upper and lower airways in chronic sinus disease patients
There is an increased incidence of chronic rhinosinusitis in lower respiratory diseases’ patients mainly with asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis and there are high prevalence rates of sinonasal symptoms in COPD ranged from 33% to 88%.
Spirometry is a piece of equipment that an individual blows into through a mouthpiece used to measure lung volume, the most commonly used test for asthmatic patients and it can diagnose airflow obstruction in patients with asthma or chronic obstructive pulmonary disease (COPD).
Sinus surgery is required for patients who still symptomatic despite maximal medical therapy, the main goals of surgery are to reduce inflamed and diseased tissue, open natural drainage pathways and allow better application of topical treatment after a lack of objective improvement on endoscopy and opacification seen on CT scans as well as a failure to improve symptoms.
So this study was done to assess the effect of functional endoscopic sinus surgery on spirometry results in patients with chronic rhinosinusitis and chronic obstructive lung diseases
60 patients were included in this study:
47 were asthmatic and 13 were COPD and all had chronic rhinosinusitis with nasal polypi.
Lund-Mackay C.T score and SNOT22 score were done preoperatively and on 3rd month postoperative
Spirometry was done preoperatively and on 1st and 3rd months postoperatively.
The results of the study are:
- Asthma was more frequently associated with chronic rhinosinusitis than COPD.
- Spirometry results improved significantly among asthmatic and COPD patients on 1st and 3rd months postoperatively.
- C.T score was significantly decreased among asthmatic and COPD patients on 3rd months postoperatively.
- SNOT22 score was significantly decreased among patients of asthma and COPD.