RESUMEN

La rinosinusitis es un determinante de la caída de la función pulmonar, la cual acompaña muy frecuentemente al asma. Está bien descrito el mecanismo por el cual la irritación continua y repetida del humo de tabaco conduce a inflamación en EPOC. Si ello es capaz de originar todo este daño y desorden a nivel del aparato respiratorio inferior, es de esperarse que también hayan cambios inflamatorios a nivel superior. Como las evidencias sugieren, el tabaquismo afecta al aparato de aclaración mucociliar a nivel nasal. Tanto la vía aérea inferior como superior están conectadas porque comparten características anatómicas y funcionales. Las exacerbaciones de EPOC se acompañan de síntomas nasales y ambos compartimentos comparten patrones bacteriológicos. La prevalencia de sinusitis en EPOC sólo se conoce a través de encuestas y va del 12 hasta 88%. El abordaje de la sinusitis en EPOC mediante el uso de tomografía computada, considerada como estándar de oro es reciente y su prevalencia es del 51%. Se ha demostrado inflamación simultánea, alta y baja, en pacientes estables y exacerbados por elevación de citocinas. El sistema respiratorio es una vía aérea única y ante todo paciente con EPOC debemos tomar en cuenta la participación nasal.

PALABRAS CLAVE

EPOC, exposición humo de tabaco, inflamación vía aérea superior, rinosinusitis.

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