Skip to main content
SpringerLink
Log in

Bronchiectasis and Chronic Rhinosinusitis

  • Chapter
  • First Online:
The Unified Airway

  • 232 Accesses

Abstract

Chronic rhinosinusitis (CRS) and bronchiectasis are alike in features of chronic mucosal inflammation and excess mucus output. While a spectrum of lower airway dysfunctions may be seen with CRS, concurrent bronchiectasis and CRS lead to more frequent lower airway exacerbations and a significant reduction in quality of life. While the concept of unified airway disease may explain this coexistence, there remains no clear link of causality. Surgical optimization of the upper airway has demonstrated significant improvement in both quality of life and pulmonary function in patients with asthma and cystic fibrosis. However, in patients with bronchiectasis, the irreversible nature of structural damage appears to limit pulmonary function improvement, although it has shown to improve quality of life and reduce the frequency of pulmonary exacerbations.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Handley E, Nicolson CH, Hew M, Lee AL. Prevalence and clinical implications of chronic rhinosinusitis in people with bronchiectasis: a systematic review. J Allergy Clin Immunol Pract. 2019;7(6):2004–2012.e1. https://doi.org/10.1016/j.jaip.2019.02.026.

    Article  PubMed  Google Scholar 

  2. Polverino E, Dimakou K, Hurst J, et al. The overlap between bronchiectasis and chronic airway diseases: state of the art and future directions. Eur Respir J. 2018;52(3):1800328. https://doi.org/10.1183/13993003.00328-2018.

    Article  PubMed  Google Scholar 

  3. King P, Holdsworth S, Freezer N, Holmes P. Bronchiectasis. Intern Med J. 2006;36(11):729–37. https://doi.org/10.1111/j.1445-5994.2006.01219.x.

    Article  CAS  PubMed  Google Scholar 

  4. Hacken ten N, Kerstjens H, Postma D. Bronchiectasis. BMJ Clin Evid. 2008;1(1507).

    Google Scholar 

  5. Aksamit TR, O’Donnell AE, Barker A, et al. Adult patients with bronchiectasis: a first look at the US Bronchiectasis Research Registry. Chest. 2017;151(5):982–92. https://doi.org/10.1016/j.chest.2016.10.055.

    Article  PubMed  Google Scholar 

  6. Hill AT, Sullivan AL, Chalmers JD, et al. British Thoracic Society Guideline for bronchiectasis in adults. Thorax. 2019;74(Suppl 1):1–69. https://doi.org/10.1136/thoraxjnl-2018-212463.

    Article  PubMed  Google Scholar 

  7. Weycker D, Hansen GL, Seifer FD. Prevalence and incidence of noncystic fibrosis bronchiectasis among US adults in 2013. Chron Respir Dis. 2017;14(4):377–84. https://doi.org/10.1177/1479972317709649.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bose S, Stevens W, Li N, et al. Unified airway theory: association of bronchiectasis and chronic rhinosinusitis. J Allergy Clin Immunol. 2016;137(Supplement):AB284. https://doi.org/10.1016/j.jaci.2015.12.1176.

    Article  Google Scholar 

  9. McCormick JP, Weeks CG, Rivers NJ, et al. Prevalence of chronic rhinosinusitis in bronchiectasis patients suspected of ciliary dyskinesia. Int Forum Allergy Rhinol. 2019;9(12):1430–5. https://doi.org/10.1002/alr.22414.

    Article  PubMed  Google Scholar 

  10. Krouse JH. The unified airway--conceptual framework. Otolaryngol Clin North Am. 2008;41(2):257–66–v. https://doi.org/10.1016/j.otc.2007.11.002.

  11. Passalacqua G. United airways disease: therapeutic aspects. Thorax. 2000;55(90002):26S–27. https://doi.org/10.1136/thorax.55.suppl_2.S26.

    Article  Google Scholar 

  12. Kern RC, Conley DB, Walsh W, et al. Perspectives on the etiology of chronic rhinosinusitis: an immune barrier hypothesis. Am J Rhinol. 2012;22(6):549–59. https://doi.org/10.2500/ajr.2008.22.3228.

    Article  Google Scholar 

  13. Sobol SE, Sobol SE, Fukakusa M, et al. Inflammation and remodeling of the sinus mucosa in children and adults with chronic sinusitis. Laryngoscope. 2003;113(3):410–4. https://doi.org/10.1097/00005537-200303000-00004.

    Article  PubMed  Google Scholar 

  14. Ha KR, Psaltis AJ, Tan L, Wormald P-J. A sheep model for the study of biofilms in rhinosinusitis. Am J Rhinol. 2007;21(3):339–45.

    Article  Google Scholar 

  15. Tieu DD, Kern RC, Schleimer RP. Alterations in epithelial barrier function and host defense responses in chronic rhinosinusitis. J Allergy Clin Immunol. 2009;124(1):37–42. https://doi.org/10.1016/j.jaci.2009.04.045.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Ramsey KA, Chen ACH, Radicioni G, et al. Airway mucus hyperconcentration in non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med. 2020;201(6):661–70. https://doi.org/10.1164/rccm.201906-1219OC.

    Article  PubMed  Google Scholar 

  17. Society ER. “Is bronchiectasis really a disease?” Michal Shteinberg, Patrick A. Flume and James D. Chalmers. Eur Respir Rev 2020; 29: 190051. Eur Respir Rev. 2020;29(155):195051. https://doi.org/10.1183/16000617.5051-2019.

  18. Chalmers JD, Chotirmall SH. Bronchiectasis: new therapies and new perspectives. Lancet Respir Med. 2018;6(9):715–26. https://doi.org/10.1016/S2213-2600(18)30053-5.

    Article  CAS  PubMed  Google Scholar 

  19. Yii ACA, Tay T-R, Choo XN, Koh MSY, Tee AKH, Wang D-Y. Precision medicine in united airways disease: a “treatable traits” approach. Allergy. 2018;73(10):1964–78. https://doi.org/10.1111/all.13496.

    Article  CAS  PubMed  Google Scholar 

  20. Ebbens FA, Fokkens WJ. The mold conundrum in chronic rhinosinusitis: where do we stand today? Curr Allergy Asthma Rep. 2008;8(2):93–101.

    Article  CAS  Google Scholar 

  21. Mac Aogáin M, Tiew PY, Lim AYH, et al. Distinct “immunoallertypes” of disease and high frequencies of sensitization in non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med. 2019;199(7):842–53. https://doi.org/10.1164/rccm.201807-1355OC.

    Article  PubMed  Google Scholar 

  22. Bienvenu T, Sermet-Gaudelus I, Burgel P-R, et al. Cystic fibrosis transmembrane conductance regulator channel dysfunction in non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med. 2010;181(10):1078–84. https://doi.org/10.1164/rccm.200909-1434OC.

    Article  CAS  PubMed  Google Scholar 

  23. Chalmers JD, McHugh BJ, Docherty C, Govan JRW, Hill AT. Vitamin-D deficiency is associated with chronic bacterial colonisation and disease severity in bronchiectasis. Thorax. 2013;68(1):39–47. https://doi.org/10.1136/thoraxjnl-2012-202125.

    Article  PubMed  Google Scholar 

  24. Somani SN, Kwah JH, Yeh C, et al. Prevalence and characterization of chronic rhinosinusitis in patients with non-cystic fibrosis bronchiectasis at a tertiary care center in the United States. Int Forum Allergy Rhinol. 2019;9(12):1424–9. https://doi.org/10.1002/alr.22436.

    Article  PubMed  Google Scholar 

  25. Guilemany JM, Angrill J, Alobid I, et al. United airways again: high prevalence of rhinosinusitis and nasal polyps in bronchiectasis. Allergy. 2009;64(5):790–7. https://doi.org/10.1111/j.1398-9995.2008.01892.x.

    Article  CAS  PubMed  Google Scholar 

  26. Psaltis AJ, Ha KR, Beule AG, Tan LW, Tan LW, Wormald P-J. Confocal scanning laser microscopy evidence of biofilms in patients with chronic rhinosinusitis. Laryngoscope. 2007;117(7):1302–6. https://doi.org/10.1097/MLG.0b013e31806009b0.

    Article  PubMed  Google Scholar 

  27. Clement S, Vaudaux P, Francois P, et al. Evidence of an intracellular reservoir in the nasal mucosa of patients with recurrent Staphylococcus aureus rhinosinusitis. J Infect Dis. 2005;192:1023–8.

    Article  Google Scholar 

  28. Niederfuhr A, Kirsche H, Deutschle T, Poppert S, Riechelmann H, Wellinghausen N. Staphylococcus aureus in nasal lavage and biopsy of patients with chronic rhinosinusitis. Allergy. 2008;63(10):1359–67. https://doi.org/10.1111/j.1398-9995.2008.01798.x.

    Article  CAS  PubMed  Google Scholar 

  29. Corriveau M-N, Zhang N, Holtappels G, Van Roy N, Bachert C. Detection of Staphylococcus aureus in nasal tissue with peptide nucleic acid-fluorescence in situ hybridization. Am J Rhinol Allergy. 2009;23(5):461–5. https://doi.org/10.2500/ajra.2009.23.3367.

    Article  PubMed  Google Scholar 

  30. Wood AJ, Fraser JD, Swift S, Patterson-Emanuelson EAC, Amirapu S, Douglas RG. Intramucosal bacterial microcolonies exist in chronic rhinosinusitis without inducing a local immune response. Am J Rhinol Allergy. 2012;26(4):265–70. https://doi.org/10.2500/ajra.2012.26.3779.

    Article  PubMed  Google Scholar 

  31. Polverino E, Goeminne PC, McDonnell MJ, et al. European Respiratory Society guidelines for the management of adult bronchiectasis. Eur Respir J. 2017;50(3):1700629. https://doi.org/10.1183/13993003.00629-2017.

    Article  PubMed  Google Scholar 

  32. Pasteur MC, Bilton D, Hill AT, British Thoracic Society Non-CF Bronchiectasis Guideline Group. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 2010;65(7):577. https://doi.org/10.1136/thx.2010.142778.

    Article  CAS  PubMed  Google Scholar 

  33. Orlandi RR, Kingdom TT, Hwang PH, et al. International consensus statement on allergy and rhinology: rhinosinusitis. Int Forum Allergy Rhinol. 2016;6 Suppl 1(S1):S22–S209. https://doi.org/10.1002/alr.21695.

    Article  PubMed  Google Scholar 

  34. Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020;58(Suppl S29):1–464. https://doi.org/10.4193/Rhin20.600.

    Article  PubMed  Google Scholar 

  35. Gramegna A, Amati F, Terranova L, et al. Neutrophil elastase in bronchiectasis. Respir Res. 2017;18(1):211–3. https://doi.org/10.1186/s12931-017-0691-x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Gaga M, Bentley AM, Humbert M, et al. Increases in CD4+ T lymphocytes, macrophages, neutrophils and interleukin 8 positive cells in the airways of patients with bronchiectasis. Thorax. 1998;53(8):685–91. https://doi.org/10.1136/thx.53.8.685.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Husain Q, Sedaghat AR. Understanding and clinical relevance of chronic rhinosinusitis endotypes. Clin Otolaryngol. 2019;44(6):887–97. https://doi.org/10.1111/coa.13455.

    Article  PubMed  Google Scholar 

  38. Wang C, Zhang L. Use of biologics in chronic sinusitis with nasal polyps. Curr Opin Allergy Clin Immunol. 2019;19(4):365–72. https://doi.org/10.1097/ACI.0000000000000540.

    Article  PubMed  Google Scholar 

  39. Odell DD, Shah A, Gangadharan SP, et al. Airway stenting and tracheobronchoplasty improve respiratory symptoms in Mounier-Kuhn syndrome. Chest. 2011;140(4):867–73. https://doi.org/10.1378/chest.10-2010.

    Article  PubMed  Google Scholar 

  40. Kanjanaumporn J, Hwang PH. Effect of endoscopic sinus surgery on bronchiectasis patients with chronic rhinosinusitis. Am J Rhinol Allergy. 2018;32(5):432–9. https://doi.org/10.1177/1945892418793539.

    Article  PubMed  Google Scholar 

  41. Wang Y, Yang H-B. Effects of functional endoscopic sinus surgery on the treatment of bronchiectasis combined with chronic rhino-sinusitis. Acta Otolaryngol. 2016;136(8):860–3. https://doi.org/10.3109/00016489.2016.1157730.

    Article  PubMed  Google Scholar 

  42. Shteinberg M, Nassrallah N, Jrbashyan J, Uri N, Stein N, Adir Y. Upper airway involvement in bronchiectasis is marked by early onset and allergic features. ERJ Open Res. 2018;4(1):00115–2017. https://doi.org/10.1183/23120541.00115-2017.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Endoscopic Sinus & Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA

    Raymond Kim & Peter H. Hwang

Authors
  1. Raymond Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter H. Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter H. Hwang .

Editor information

Editors and Affiliations

  1. Otolaryngology – Head & Neck Surgery, Columbia University, New York, NY, USA

    David A. Gudis

  2. Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA

    Rodney J. Schlosser

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kim, R., Hwang, P.H. (2020). Bronchiectasis and Chronic Rhinosinusitis. In: Gudis, D., Schlosser, R. (eds) The Unified Airway. Springer, Cham. https://doi.org/10.1007/978-3-030-50330-7_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-50330-7_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-50329-1

  • Online ISBN: 978-3-030-50330-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation