76 / 236
and inflammatory process. On nasal endoscopy, NAScA
had significantly more polyps than the control group,
whereas NASsA did not. On histologic examination,
NAScA has higher amounts of eosinophils, mast cells,
and cellularity than NASsA and control group. Mast
cell, hypercellularity, and eosinophils are more consist-
ent with a noninfectious inflammation that is similar to
AScA. Therefore, for these NAScA patients, an acute
Fig. 6. Algorithm to diagnose the
subclasses of chronic rhinosinusitis
based on clinical history and testing.
AERD
5
aspirin-exacerbated respira-
tory disease; AFS
5
allergic fungal
sinusitis; AScA
5
asthmatic sinusitis
with allergy; ASsA
5
asthmatic sinus-
itis without allergy; CT
5
computed
tomography; NAScA
5
nonasthmatic
sinusitis with allergy;
NAS-
sA
5
nonasthmatic sinusitis without
allergy.
Fig. 7. Chart summarizing the phenotype for each subclass of
CRS. AERD
5
aspirin-exacerbated respiratory disease; AFS
5
aller-
gic fungal sinusitis; AS
5
aspirin sensitive; CF
5
cystic fibrosis;
CT
5
computed tomography; NAS
5
nonasthmatic.
Fig. 8. Coronal computed tomography of the sinus demonstrating
obstructive chronic sinusitis typical of nonasthmatic sinusitis with-
out allergy.
Han: Subclassification of Chronic Sinusitis
Laryngoscope
123: March
2013
54