Sicca Symptoms and their Association with Chronic Rhinosinusitis in a Community Sample

S Lester1, 2, M Rischmueller1, 2, 3, LW Tan1, 4, PJ Wormald1, 4, P Zalewski1, 3, MA Hamilton-Bruce1, 5, S Appleton3, RJ Adams3, CL Hill*, 1, 2, 3
1 Centre for Inflammatory Disease Research (CIDR), The Basil Hetzel Institute for Translational Health Research, Woodville South, SA, Australia
2 Rheumatology Department, The Queen Elizabeth Hospital, Woodville South, SA, Australia
3 Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital, Woodville South, SA, Australia
4 Department of Surgery – Otolaryngology Head and Neck Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville South, SA, Australia
5 Stroke Research Program and Neurology Department, University of Adelaide School of Medicine, The Queen Elizabeth Hospital, Woodville South, SA, Australia

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© Lester et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited..

* Address correspondence to these authors at the Rheumatology Department, The Queen Elizabeth Hospital, Woodville Road, Woodville South, South Australia, 5011, Australia; Tel: 61-8-81226688; Fax: 61-8-82227156; E-mail:



To determine associations between sicca symptoms, chronic rhinosinusitis (CRS) symptoms and asthma in a community survey.


Data was obtained from the Spring 2009 South Australian Health Omnibus Survey which sampled, via interviewer administered questionnaire, 3007 individuals aged 15 years and over whose socio-demographic distribution corresponded to South Australian population estimates. Respondents were asked a range of questions relating to the presence of persistent dry eyes or dry mouth, CRS and medically diagnosed nasal polyps and asthma. Relationships between symptoms were explored using maximum likelihood dependency tree analysis.


The respective population prevalences were: dry mouth (5.9%), dry eyes (8.6%), nasal polyps (3.8%), CRS (13.2%) and asthma (12.0%). The overall prevalence of sicca symptoms (dry eyes or dry mouth) was 12.4%. Dependency tree analysis revealed the expected symptom clustering between (1) sicca symptoms and their association with female gender and increasing age and (2) CRS, nasal polyps and asthma (one airway hypothesis). However there was also an association between dry eyes and CRS (OR 2.5, 95% CI 1.9, 3.4), which was in fact stronger than the association between CRS and asthma (OR 1.9, 95% CI 1.4, 2.5).


Sicca symptoms are common in the community. Our novel finding of a strong association between dry eyes and CRS suggests that further research into the relationship between airway inflammation and sicca symptoms is required. These findings may have particular relevance to Sjögren’s syndrome (SS) in both its primary and secondary forms.

Keywords: Sicca syndrome, rhinosinusitis, nasal polyps, asthma, prevalence..