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Ragweed Allergic Rhinitis and the Paranasal Sinuses: A Computed Tomographic Study

Ragweed Allergic Rhinitis and the Paranasal Sinuses: A Computed Tomographic Study Abstract Objective: To explore the potential association of allergic rhinitis and sinusitis. Design: Prospective clinical trial. Setting: Academic tertiary referral center. Participants: Ten subjects with symptomatic ragweed allergy during the peak of the ragweed season. Main Outcome Measures: We obtained a paranasal sinus computed tomographic scan on all volunteers and had them complete a modified Rhinitis Quality of Life Questionnaire. All subjects were then treated with intranasal aqueous beclomethasone dipropionate (168 μg twice a day) and completed the Rhinitis Quality of Life Questionnaire weekly until the end of the study. Results: Six of 10 of the subjects had sinus mucosal thickening on computed tomographic scan. All subjects improved symptomatically. A second computed tomographic scan was obtained after the pollen season in 5 patients with mucosal abnormalities, while the patients continued treatment with intranasal steroids and symptomatically improved. The sinus mucosal abnormalities persisted in all patients. Conclusion: Despite the 60% incidence of abnormalities on the computed tomographic scans of the subjects with ragweed allergy during the season, these abnormalities appear, at most, to contribute minimally to the patient's symptoms, since resolution of symptoms was not accompanied by a reduction in sinus mucosal abnormalities.Arch Otolaryngol Head Neck Surg. 1997;123:193-196 References 1. van Dishoeck H, Franssen M. The incidence and correlation of allergy and chronic maxillary sinusitis . Pract Otolaryngol . 1957;19:502-506. 2. Benninger M. Rhinitis, sinusitis and their relationships to allergies . Am J Rhinol . 1992;6:37-43.Crossref 3. Grove R, Farrior J. Chronic hyperplastic sinusitis in allergic patients: a bacteriologic study of two hundred operative cases . J Allergy . 1990;11:271-276.Crossref 4. Friedman W. Surgery for chronic hyperplastic rhinosinusitis . Laryngoscope . 1975;85:199-211. 5. Savolainen S. Allergy in patients with acute maxillary sinusitis . Allergy . 1989; 44:116-122.Crossref 6. Rachelefsky G, Goldberg M, Katz R, et al. Sinus disease in children with respiratory allergy . J Allergy Clin Immunol . 1978;61:310-314.Crossref 7. Shapiro G. Role of allergy in sinusitis . Pediatr Infect Dis .1985;4:555-558.Crossref 8. Enberg R. Perennial nonallergic rhinitis: a retrospective review . Ann Allergy . 1989;63:513-516. 9. Conner BL, Roach ES, Laster WS, Georgitis JW. Magnetic resonance imaging of the paranasal sinuses: frequency and type of abnormalities . Ann Allergy . 1989;62:457-460. 10. Zinreich SJ, Kennedy DW, Rosenbaum AE, Gayler BW, Kumar AJ, Stammberger H. Paranasal sinuses: CT imaging requirements for endoscopic surgery . Radiology . 1987;163:769-775.Crossref 11. Lund VJ, MacKay IS. Staging in rhinosinusitis . Rhinology . 1993;31:183-184. 12. Juniper EF, Guyatt GH. Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis . Clin Exp Allergy . 1991;21:77-83.Crossref 13. Naclerio RM, Mygind N. Intranasal steroids . In: Mygind N, Naclerio RM, eds. Allergic and Nonallergic Rhinitis: Clinical Aspects . Copenhagen, Denmark: Munksgaard; 1993:114-122. 14. Stammberger H. Endoscopic endonasal surgery: concepts in treatment of recovering rhinosinusitis, I: anatomic and pathophysiological considerations . Otolaryngol Head Neck Surg . 1986;94:143-147. 15. Drettner B. The paranasal sinuses . In: Proctor D, Andersen I, eds. The Nose . Amsterdam, the Netherlands: Elsevier Science Publishers; 1982:145-162. 16. Deitmer T, Scheffler R. Nasal physiology in swimmers and swimmers' sinusitis . Acta Otolaryngol (Stockh) . 1990;110:286-291.Crossref 17. Washburn RG, Kennedy D, Begley M, Henderson D, Bennett J. Chronic fungal sinusitis in apparently normal hosts . Medicine . 1988;67:231-247.Crossref 18. Skoner DP, Whiteside TL, Wilson JW, Doyle WJ, Herberman RB, Fireman P. Effect of rhinovirus 39 infection on cellular immune parameters in allergic and nonallergic subjects . J Allergy Clin Immunol . 1993;92:732-743.Crossref 19. Harlin S, Ansel D, Lane S, Myers J, Kephart G, Gleich G. A clinical and pathologic study of chronic sinusitis: the role of the eosinophil . J Allergy Clin Immunol . 1988;81:867-875.Crossref 20. Baroody FM, Hughes A, Hruban R, MacDowell P, Naclerio RM. Eosinophilia in chronic childhood sinusitis . Arch Otolaryngol Head Neck Surg . 1995;121:1396-1402.Crossref 21. Hamilos DL, Leung DV, Wood R, et al. Evidence for distinct cytokine expression in allergic versus nonallergic chronic sinusitis . J Allergy Clin Immunol . 1996;96:537-544.Crossref 22. Pelikan Z, Pelikan-Filipek M. Role of nasal allergy in chronic maxillary sinusitis: diagnostic value of nasal challenge with allergen . J Allergy Clin Immunol . 1990;86:484-491.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Ragweed Allergic Rhinitis and the Paranasal Sinuses: A Computed Tomographic Study

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References (25)

Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1997.01900020077011
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective: To explore the potential association of allergic rhinitis and sinusitis. Design: Prospective clinical trial. Setting: Academic tertiary referral center. Participants: Ten subjects with symptomatic ragweed allergy during the peak of the ragweed season. Main Outcome Measures: We obtained a paranasal sinus computed tomographic scan on all volunteers and had them complete a modified Rhinitis Quality of Life Questionnaire. All subjects were then treated with intranasal aqueous beclomethasone dipropionate (168 μg twice a day) and completed the Rhinitis Quality of Life Questionnaire weekly until the end of the study. Results: Six of 10 of the subjects had sinus mucosal thickening on computed tomographic scan. All subjects improved symptomatically. A second computed tomographic scan was obtained after the pollen season in 5 patients with mucosal abnormalities, while the patients continued treatment with intranasal steroids and symptomatically improved. The sinus mucosal abnormalities persisted in all patients. Conclusion: Despite the 60% incidence of abnormalities on the computed tomographic scans of the subjects with ragweed allergy during the season, these abnormalities appear, at most, to contribute minimally to the patient's symptoms, since resolution of symptoms was not accompanied by a reduction in sinus mucosal abnormalities.Arch Otolaryngol Head Neck Surg. 1997;123:193-196 References 1. van Dishoeck H, Franssen M. The incidence and correlation of allergy and chronic maxillary sinusitis . Pract Otolaryngol . 1957;19:502-506. 2. Benninger M. Rhinitis, sinusitis and their relationships to allergies . Am J Rhinol . 1992;6:37-43.Crossref 3. Grove R, Farrior J. Chronic hyperplastic sinusitis in allergic patients: a bacteriologic study of two hundred operative cases . J Allergy . 1990;11:271-276.Crossref 4. Friedman W. Surgery for chronic hyperplastic rhinosinusitis . Laryngoscope . 1975;85:199-211. 5. Savolainen S. Allergy in patients with acute maxillary sinusitis . Allergy . 1989; 44:116-122.Crossref 6. Rachelefsky G, Goldberg M, Katz R, et al. Sinus disease in children with respiratory allergy . J Allergy Clin Immunol . 1978;61:310-314.Crossref 7. Shapiro G. Role of allergy in sinusitis . Pediatr Infect Dis .1985;4:555-558.Crossref 8. Enberg R. Perennial nonallergic rhinitis: a retrospective review . Ann Allergy . 1989;63:513-516. 9. Conner BL, Roach ES, Laster WS, Georgitis JW. Magnetic resonance imaging of the paranasal sinuses: frequency and type of abnormalities . Ann Allergy . 1989;62:457-460. 10. Zinreich SJ, Kennedy DW, Rosenbaum AE, Gayler BW, Kumar AJ, Stammberger H. Paranasal sinuses: CT imaging requirements for endoscopic surgery . Radiology . 1987;163:769-775.Crossref 11. Lund VJ, MacKay IS. Staging in rhinosinusitis . Rhinology . 1993;31:183-184. 12. Juniper EF, Guyatt GH. Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis . Clin Exp Allergy . 1991;21:77-83.Crossref 13. Naclerio RM, Mygind N. Intranasal steroids . In: Mygind N, Naclerio RM, eds. Allergic and Nonallergic Rhinitis: Clinical Aspects . Copenhagen, Denmark: Munksgaard; 1993:114-122. 14. Stammberger H. Endoscopic endonasal surgery: concepts in treatment of recovering rhinosinusitis, I: anatomic and pathophysiological considerations . Otolaryngol Head Neck Surg . 1986;94:143-147. 15. Drettner B. The paranasal sinuses . In: Proctor D, Andersen I, eds. The Nose . Amsterdam, the Netherlands: Elsevier Science Publishers; 1982:145-162. 16. Deitmer T, Scheffler R. Nasal physiology in swimmers and swimmers' sinusitis . Acta Otolaryngol (Stockh) . 1990;110:286-291.Crossref 17. Washburn RG, Kennedy D, Begley M, Henderson D, Bennett J. Chronic fungal sinusitis in apparently normal hosts . Medicine . 1988;67:231-247.Crossref 18. Skoner DP, Whiteside TL, Wilson JW, Doyle WJ, Herberman RB, Fireman P. Effect of rhinovirus 39 infection on cellular immune parameters in allergic and nonallergic subjects . J Allergy Clin Immunol . 1993;92:732-743.Crossref 19. Harlin S, Ansel D, Lane S, Myers J, Kephart G, Gleich G. A clinical and pathologic study of chronic sinusitis: the role of the eosinophil . J Allergy Clin Immunol . 1988;81:867-875.Crossref 20. Baroody FM, Hughes A, Hruban R, MacDowell P, Naclerio RM. Eosinophilia in chronic childhood sinusitis . Arch Otolaryngol Head Neck Surg . 1995;121:1396-1402.Crossref 21. Hamilos DL, Leung DV, Wood R, et al. Evidence for distinct cytokine expression in allergic versus nonallergic chronic sinusitis . J Allergy Clin Immunol . 1996;96:537-544.Crossref 22. Pelikan Z, Pelikan-Filipek M. Role of nasal allergy in chronic maxillary sinusitis: diagnostic value of nasal challenge with allergen . J Allergy Clin Immunol . 1990;86:484-491.Crossref

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Feb 1, 1997

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