Retrospective Study: Association of Chronic Sphenoid Rhinosinusitis With Community Acquired Pneumonia

Objectives: Our objective in this study is to examine the association between chronic sphenoid rhinosinusitis and community acquired pneumonia (CAP). Study Design: Retrospective chart review. Methods: A list of chronic rhinosinusitis (CRS) patients who presented to a tertiary rhinology clinic from 2013 to 2015 was conducted. Patients were excluded if they were not seen for at least 2 years. Patients were categorized into CRS with sphenoid sinusitis (group A) and CRS without sphenoid sinusitis (group B). The former group was divided into 2 categories according to their computed tomography scan/endoscopy findings: mucosal thickening and opacification (partial, complete, purulent sphenoid drainage on endoscopy). Posterior ethmoid disease was analyzed in the same fashion. Charts were then reviewed on whether the patients developed CAP within 2 years of their visit to the rhinologist. Results: Six hundred forty-five of 1061 patients were included in the analysis. There were 178 (27.60%) patients in group A and 467 (72.40%) patients in group B. There were 40 total cases of pneumonia with 27 (67.50%) cases having chronic sphenoid sinusitis. Patients with sphenoid sinusitis were 6.77 (95% confidence interval [CI], 3.36–13.66) times more likely to have pneumonia. Patients with partial/complete opacification of the sphenoid sinus were 19.76 (95% CI, 8.78–44.47) times more likely to have pneumonia. Patients with only mucosal thickening of the sphenoid sinus did not have significantly increased odds of having pneumonia. Posterior ethmoid disease did not have an association with CAP nor did it increase the risk of CAP in sphenoid sinusitis patients. Conclusions: There is an association between chronic sphenoid rhinosinusitis and CAP. Partial/complete opacification of the sphenoid sinus had the highest association with pneumonia.