Exposing patients with chronic sinus disease to allergens and then obtaining repeated images by X-ray or ultrasound reveals that nasal allergies may be involved in some cases of chronic sinus disease, according to a report in the December issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.
Chronic disease of the maxillary sinus (the sinus cavity located in the mid-face beneath the cheeks, on either side of the nose) is common and affects a wide population of adults and children, according to background information in the article. "Although the involvement of hypersensitivity mechanisms, and especially of nasal allergy, in chronic disease of the maxillary sinuses has been recognized, the diagnostic procedures for this disorder and the relationship vary," the author writes. "There is a dearth of information regarding the direct causal involvement of hypersensitivity mechanisms of the nasal mucosa and potential consequences within the maxillary sinuses."
Zdenek Pelikan, M.D., Ph.D., of Allergy Research Foundation, Breda, the Netherlands, studied 71 patients with chronic maxillary sinus disease and 16 control individuals with allergic rhinitis but no history of sinus disease. The patients with sinus disease underwent a total of 135 nasal provocation tests, in which allergens were applied to the linings of their nasal cavities, and 71 control challenges in which only phosphate-buffered saline was applied. In the control patients, 16 positive nasal provocation tests were repeated. Before and repeatedly after these tests and challenges, images were taken of the maxillary sinuses using both radiography (X-rays) and ultrasonography. Changes to the skeleton, air fluid level, thickening of the mucus membrane in the sinus and other parameters were noted.