Fractional Exhaled Nitric Oxide for Diagnosing Eosinophilic Chronic Rhinosinusitis: A Systematic Review and Meta-analysis.

Abstract

The current gold standard for diagnosing eosinophilic chronic rhinosinusitis (ECRS) is tissue biopsy, but due to its invasive nature, there is a need for clinical diagnosis in outpatient settings or presurgical evaluations. PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus up to July 2024. Compared the fractional exhaled nitric oxide (FeNO) levels between ECRS and non-ECRS patients. The risk of bias across studies was evaluated utilizing the ROBINS-I tool. Twelve studies comprising 1159 participants were included. The pooled mean difference in FeNO levels between ECRS and non-ECRS patients was 32.21 ppb (95% CI: [19.36, 45.06], P < .001). The diagnostic odds ratio for FeNO in identifying ECRS was 8.78 (95% CI: [5.70, 13.51], P < .001). FeNO levels are significantly elevated in ECRS patients compared to non-ECRS patients. The high diagnostic odds ratio suggests that FeNO has potential as a noninvasive diagnostic tool for ECRS.