NEW YORK (Reuters Health), Dec 23 - In patients with chronic maxillary sinus disease, an allergic etiology can be confirmed using serial ultrasound exams to monitor responses to nasal allergen challenge.
This finding, reported by Dr. Zdenek Pelikan from the Allergy Research Foundation in Breda, the Netherlands, comes from a study published in the December Archives of Otolaryngology--Head and Neck Surgery.
In 71 patients with maxillary sinus disease of at least 3 years' duration and 16 control subjects with allergic rhinitis, Dr. Pelikan compared the results of ultrasonography and conventional radiography before and immediately after nasal provocation testing.
During 135 nasal provocation tests, 67 patients developed 104 positive nasal responses, with radiographic changes accompanying 89 responses and ultrasonographic changes associated with 83 responses. There was significant agreement between the positive nasal responses and the appearance of the sinus changes.
None of the control subjects showed radiographic or ultrasonographic changes after nasal provocation tests. Furthermore, none of the patients with sinus disease had imaging changes after sham challenges with saline, according to the article.
The correlation between radiographic and ultrasonographic changes was highly significant both for positive results (r = 0.89, p < 0.001) and negative results (r = - 0.73, p < 0.01), Dr. Pelikan reports.
Dr. Pelikan notes that ultrasonography reliably evaluates mucosal thickening along the anterior and posterior sinus wall, as well as fluid level.
He also points out that that hypersensitivity mechanisms require serial imaging, for which ultrasonography is well suited due to its low cost and lack of radiation exposure, and "the possibility of its use also in extramural offices."
Arch Otolaryngol Head Neck Surg 2009;135:1246-1255.
Last Updated: 2009-12-22 19:15:09 -0400 (Reuters Health)
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