Nitric oxide as a screening tool for evaluation of postoperative state of chronic rhinosinusitis

Background: Nitric oxide might have a various roles in development or defense of the upper airway inflammation. Fractional exhaled nitric oxide (FeNO) and nasal nitric oxide (nNO) are used as a screening tool to evaluate the airway inflammation such as chronic rhinosinusitis (CRS), allergic rhinitis and so on. But whether the level of FeNO or nNO is increased or decreased at each disease is not evident. This study was performed to assess whether FeNO can be used the screening tool for evaluation of CRS patients and whether it can be used to evaluate postoperative state of CRS.

Methods: Thirty patients with CRS and twenty normal control group were recruited. The FeNO measurement was performed using a handheld electrochemical analyzer (NObreath®) through the nasal and oral route and the mean value of the 3 consecutive measurements was recorded. Nasal FeNO and oral FeNO were checked preoperatively and postop-1 month and 3 months.

Results: Preoperative nasal and oral FeNO (nasal: 62.02 ± 45.03 ppb, oral: 30.63 ± 17.71 ppb) in patients with CRS were significantly higher than normal control group (nasal: 25.53 ± 10.52 ppb, oral: 14.45 ± 7.69 ppb, p=0.0001). Nasal and oral FeNO were decreased after operation in time manner. Three month after operation, nasal FeNO and oral FeNO were significantly decreased compared to preoperative level (nasal: 62.02 ± 45.03 ppb vs. 37.68 ± 26.26 ppb, oral: 30.63 ± 17.71 ppb vs. 24.79 ± 19.24 ppb, p<0.05).

Conclusions: The FeNO could be used for the screening tool to assess the evaluation of CRS patients. Also it can be used to evaluate postoperative state of CRS through the change of FeNO level.