Baseline Comparison of Nasal Nitric Oxide Levels and Nasal Patency in Chronic Rhinosinusitis Patients and Healthy Controls
Abstract
Introduction: Chronic rhinosinusitis (CRS) affects approximately 11% of the adult population in the United States. Current diagnostic methods often involve invasive procedures or imaging. Nasal nitric oxide (nNO), crucial for local defense mechanisms and ciliary motility, shows promise as a non-invasive biomarker for sinonasal diseases. Previous studies suggest altered nNO levels in CRS patients, but results have been inconsistent. This study, part of a larger longitudinal investigation, compares baseline nNO levels and nasal patency between CRS patients and healthy controls.
Methods: This cross-sectional, case-control study enrolled 11 CRS patients and 8 healthy controls in the EVMS ENT Clinic. During a single visit, fractional exhaled nitric oxide (FeNO) and nNO were measured using the NIOX VERO system. Nasal patency was assessed via acoustic rhinometry at 0cm, 2cm, 4cm, and 6cm depths bilaterally using the A1 Clinical Research Acoustic Rhinometer. Data analysis included calculation of means, standard deviations, and unpaired t-tests for between-group comparisons. While the small sample size limits the ability to confirm normality, t-tests were used for consistency with the planned larger longitudinal study (n150).
Results: Mean nNO levels were lower in the CRS group (270 ± 260 ppb) compared to the healthy group (641 ± 458 ppb), with a trend toward significance (p = 0.044). Mean FeNO levels were higher in the CRS group (37.7 ± 17.7 ppb) compared to the healthy group (28.4 ± 23.1 ppb), though not statistically significant (p = 0.33). Acoustic rhinometry revealed no statistically significant differences in nasal patency between groups at any measured depth.
Conclusion: This study reveals significantly lower nNO levels in CRS patients compared to healthy controls, supporting its potential as a non-invasive biomarker for CRS. Although no statistically significant differences were observed in nasal patency or FeNO levels between groups, the limited sample size warrants cautious interpretation of these results. As part of our larger longitudinal investigation, future assessments at 6 and 12 weeks post-intervention will help elucidate the relationship between osteomeatal complex patency, nNO levels, and CRS disease activity.