Computed Tomography to Evaluate Chronic Sinusitis

To the Editor. —The recent article by Dr Newman and associates1demonstrated a strong correlation between extensive sinus disease on CT scan and peripheral eosinophilia. This relationship was highly significant even in patients without a history of wheezing or specific IgE antibodies. They suggested that sinus inflammation, rather than asthma or allergy, is the stimulus for the eosinophilia. We have observed an interesting relationship between peripheral eosinophilia and chronic sinusitis in patients with nasal polyps. The Figure demonstrates monthly eosinophil counts in a 47-year-old man with nasal polyposis and asthma. These counts dropped dramatically when the polyp load was reduced by either surgical polypectomy or a methylprednisolone bolus of 20 mg per day for 2 weeks with a 2-week taper. A rebound in eosinophil counts was observed following both surgical and medical therapies, corresponding to a recurrence of the polyps on clinical examination. Newman et al did not report