Investigating Children with Respiratory Allergy for Undiagnosed Rhinosinusitis
Eman Mohammad Saeid Moustafa;
Abstract
Untreated allergic rhinitis not only detrimentally, affect children physical and psychosocial well-being, quality of life, and capacity to function and learn, but it is also associated with and may contribute to potentially serious comorbidities, including asthma, sinusitis, and otitis media.
This study is aimed to investigate a group of atopic children with physician-diagnosed allergic rhinitis for the presence of documented sinusitis. The ultimate objective is to provide adequate therapy and reduce morbidity.
This cross-sectional studywas carriedon 50 atopic Egyptian children with physician diagnosed allergic rhinitis, and clinical symptoms suggestive of sinusitis.
Detailed history taking and clinical examination, skin prick testing,CT scan of the paranasal sinuses, and direct visualization of nasal passages were performed for each patient In addition,laboratoryevaluation including complete blood counts, total serum IgE and CRP measurement was carried out.
In the current study, the most frequent symptom of AR werenasal discharge, nasal obstruction and cough. Facial pain and facial bone tenderness were found in only 16% of cases. Seasonal exacerbations were found among 56% of whomwinter season exacerbation was the most claimed season followed by spring season, while persistent perennial symptoms were observed in 44% of studied cases. It was also clear that the frequency of sinusitis ( (76.0%) and asthma ( (64.0%) among AR children is high.
In current study, CT evidence of sinusitis observed in 76% of patients, 66% of them had maxillary sinusitis, 56% had ethmoidal sinusitis, 40% had frontal sinusitis and 38% had parasinusitis. Two( (4%) cases had radiological findings suggestive ofAFRSwith positive SPT to aspergillus.This study showed that radiological evidence of sinusitis did not have significant impacts onsymptoms of AR/BA, severity or control of allergic diseases.
Nasal endoscopy was used for direct visualization of the nasal passages in cooperative children and revealed signs of allergic rhinitis which included pale bluish nasal mucosa, hypertrophied inferior turbinate and thick secretion from sinus ostia. However, clear evidence of sinusitis was present in only 2 patients.
Concerning SPT results, house dust mite( (HDM) was the most commonly encountered allergen followed by alternaria and cockroaches.Twenty two percent of patients had positive skin test to one or more of the food allergens, fish was the most commonly encountered allergen( (10%) followed by eggs, peanuts and sesame, and tomatoes.
From our study, we can conclude that radiological findings suggestive of sinusitis is present in a significant proportion of patients with allergic rhinitis, albeit, we could not find significant impact of its presence on the patients’ allergic disease severity and control. The presence of facial pain and/or tenderness on examination is a significant clinical sign indicating sinusitis.
This study is aimed to investigate a group of atopic children with physician-diagnosed allergic rhinitis for the presence of documented sinusitis. The ultimate objective is to provide adequate therapy and reduce morbidity.
This cross-sectional studywas carriedon 50 atopic Egyptian children with physician diagnosed allergic rhinitis, and clinical symptoms suggestive of sinusitis.
Detailed history taking and clinical examination, skin prick testing,CT scan of the paranasal sinuses, and direct visualization of nasal passages were performed for each patient In addition,laboratoryevaluation including complete blood counts, total serum IgE and CRP measurement was carried out.
In the current study, the most frequent symptom of AR werenasal discharge, nasal obstruction and cough. Facial pain and facial bone tenderness were found in only 16% of cases. Seasonal exacerbations were found among 56% of whomwinter season exacerbation was the most claimed season followed by spring season, while persistent perennial symptoms were observed in 44% of studied cases. It was also clear that the frequency of sinusitis ( (76.0%) and asthma ( (64.0%) among AR children is high.
In current study, CT evidence of sinusitis observed in 76% of patients, 66% of them had maxillary sinusitis, 56% had ethmoidal sinusitis, 40% had frontal sinusitis and 38% had parasinusitis. Two( (4%) cases had radiological findings suggestive ofAFRSwith positive SPT to aspergillus.This study showed that radiological evidence of sinusitis did not have significant impacts onsymptoms of AR/BA, severity or control of allergic diseases.
Nasal endoscopy was used for direct visualization of the nasal passages in cooperative children and revealed signs of allergic rhinitis which included pale bluish nasal mucosa, hypertrophied inferior turbinate and thick secretion from sinus ostia. However, clear evidence of sinusitis was present in only 2 patients.
Concerning SPT results, house dust mite( (HDM) was the most commonly encountered allergen followed by alternaria and cockroaches.Twenty two percent of patients had positive skin test to one or more of the food allergens, fish was the most commonly encountered allergen( (10%) followed by eggs, peanuts and sesame, and tomatoes.
From our study, we can conclude that radiological findings suggestive of sinusitis is present in a significant proportion of patients with allergic rhinitis, albeit, we could not find significant impact of its presence on the patients’ allergic disease severity and control. The presence of facial pain and/or tenderness on examination is a significant clinical sign indicating sinusitis.
Other data
| Title | Investigating Children with Respiratory Allergy for Undiagnosed Rhinosinusitis | Other Titles | استكشاف التهاب الجيوب الأنفية في الأطفال المصابين بحساسية الجهاز التنفسى | Authors | Eman Mohammad Saeid Moustafa | Issue Date | 2017 |
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