Imaging tests identify role of allergies in chronic sinus disease

[Guest guest]

And no one thought of doing a culture for fungi?? 

--In conclusion, nasal allergy may be involved in chronic disease of the

maxillary sinuses in some patients, " the author concludes. " Nasal

challenge with allergen combined with ultrasonography and, if

necessary, also with one of the radiographic imaging methods may be a

useful supplement for the diagnosis of this disorder in the clinical

practice, especially in children. The confirmation of involvement of

nasal allergy in patients with chronic disease of the maxillary sinuses

would indicate an additional treatment of the nasal allergy. "

>

Imaging tests identify role of allergies in chronic sinus disease  

http://www.eurekalert.org/pub_releases/2009-12/jaaj-iti121709.php

  

 

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.

 

Of the 71 patients with sinusitis, 67 developed 104 positive nasal responses to

the provocation tests. Of these, 89 were accompanied by significant changes to

the maxillary sinus on radiographs and 83 were also associated with significant

changes on ultrasonograms. No significant changes on radiographs or

ultrasonograms were noted during the 71 saline control tests on patients with

sinus disease, or during the 16 nasal provocation tests conducted on control

patients without sinus disease.

 

" The possible involvement of allergy, and especially of nasal allergy, in some

forms of sinus disease has already been reported in the literature, " the author

writes. " There are a number of anatomic and physiologic similarities between the

nasal mucosa and mucosa of the maxillary sinuses. " The maxillary sinuses open

into the nasal canal through a valve known as the ostium. If mucus membranes in

the nasal cavity are swollen, the ostium can become blocked, trapping fluids in

the sinus.

 

###

(Arch Otolaryngol Head Neck Surg. 2009;135[12] :1246-1255. Available pre-embargo

to the media at www.jamamedia. org.)

Editor's Note: Please see the article for additional information, including

author contributions and affiliations, financial disclosures, funding and

support, etc.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA

(5262) or e-mail mediarelations@ jama-archives. org.

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[Guest guest]

Thanks K,

If mucus membranes in the nasal cavity are swollen, the ostium can become

blocked, trapping fluids in the sinus.

this happens with me quite a bit if I dont keep my sinuses washed often, when it

does it also stops the sinus wash from getting in there without pushing up and

out on my cheek to open it up some. I than can get some pretty bad frontal

headackes as a result.

and pressure to my eyes. so for me washing my sinuses helps with several things.

I modified a couple of those store bought sinus washes (and my brain didn't care

for something that was in their sinus wash which smelled like something close to

purfume)

by makeing the hole a little bigger where you squezze out the fluid

so that it actually does wash the sinuses instead of just wet your sinuses and I

can put my sinus wash in them and take them with me if I go somewhere.

>

> And no one thought of doing a culture for fungi?? 

>

> --In conclusion, nasal allergy may be involved in chronic disease of the

> maxillary sinuses in some patients, " the author concludes. " Nasal

> challenge with allergen combined with ultrasonography and, if

> necessary, also with one of the radiographic imaging methods may be a

> useful supplement for the diagnosis of this disorder in the clinical

> practice, especially in children. The confirmation of involvement of

> nasal allergy in patients with chronic disease of the maxillary sinuses

> would indicate an additional treatment of the nasal allergy. "