1.Diagnosis of Allergic Rhinitis.
Korean Journal of Medicine 2013;85(5):452-456
Rhinitis is divided into allergic and non-allergic rhinitis. Non-allergic rhinitis includes inflammatory rhinitis, such as non-allergic rhinitis with eosinophilia syndrome (NARES) and infective rhinitis, and non-inflammatory rhinitis, such as vasomotor rhinitis and idiopathic rhinitis. Allergic rhinitis is diagnosed based on the presence of allergen-specific IgE and the documentation of relationship between the allergen and symptoms in patients with typical rhinitis symptoms, such as rhinorrhea, nasal obstruction, itchiness and/or sneezing. Local allergic rhinitis can be considered for differential diagnosis. Allergic rhinitis should be differentiated from non-allergic rhinitis by using skin prick test, serum specific IgE test, nasal cytology and/or allergen nasal provocation test. Allergic rhinitis should be differentiated from structural nasal diseases, such as septal deviation and nasal polyps. Rhinitis is frequently accompanied by paranasal sinusitis, which should be recognized in clinical practice. Management strategies differ between allergic and nonallergic rhinitis. In addition to pharmacotherapy, allergen avoidance and allergen-specific immunotherapy can be tried in patients with allergic rhinitis. Thus, the exact diagnosis is very important for the effective treatment in allergic rhinitis. The diagnostic tests for allergic rhinitis are reviewed.
Cell Biology
;
Diagnosis*
;
Diagnosis, Differential
;
Diagnostic Tests, Routine
;
Drug Therapy
;
Eosinophilia
;
Humans
;
Immunoglobulin E
;
Immunotherapy
;
Nasal Obstruction
;
Nasal Polyps
;
Nasal Provocation Tests
;
Nose Diseases
;
Rhinitis*
;
Rhinitis, Allergic, Perennial
;
Rhinitis, Vasomotor
;
Sinusitis
;
Skin
;
Skin Tests
;
Sneezing
2.Diagnosis of Allergic Rhinitis.
Korean Journal of Medicine 2013;85(5):452-456
Rhinitis is divided into allergic and non-allergic rhinitis. Non-allergic rhinitis includes inflammatory rhinitis, such as non-allergic rhinitis with eosinophilia syndrome (NARES) and infective rhinitis, and non-inflammatory rhinitis, such as vasomotor rhinitis and idiopathic rhinitis. Allergic rhinitis is diagnosed based on the presence of allergen-specific IgE and the documentation of relationship between the allergen and symptoms in patients with typical rhinitis symptoms, such as rhinorrhea, nasal obstruction, itchiness and/or sneezing. Local allergic rhinitis can be considered for differential diagnosis. Allergic rhinitis should be differentiated from non-allergic rhinitis by using skin prick test, serum specific IgE test, nasal cytology and/or allergen nasal provocation test. Allergic rhinitis should be differentiated from structural nasal diseases, such as septal deviation and nasal polyps. Rhinitis is frequently accompanied by paranasal sinusitis, which should be recognized in clinical practice. Management strategies differ between allergic and nonallergic rhinitis. In addition to pharmacotherapy, allergen avoidance and allergen-specific immunotherapy can be tried in patients with allergic rhinitis. Thus, the exact diagnosis is very important for the effective treatment in allergic rhinitis. The diagnostic tests for allergic rhinitis are reviewed.
Cell Biology
;
Diagnosis*
;
Diagnosis, Differential
;
Diagnostic Tests, Routine
;
Drug Therapy
;
Eosinophilia
;
Humans
;
Immunoglobulin E
;
Immunotherapy
;
Nasal Obstruction
;
Nasal Polyps
;
Nasal Provocation Tests
;
Nose Diseases
;
Rhinitis*
;
Rhinitis, Allergic, Perennial
;
Rhinitis, Vasomotor
;
Sinusitis
;
Skin
;
Skin Tests
;
Sneezing
3.Measurement of Nasal and Exhaled Nitric Oxide in Nasal Disease.
Myung Chul SHIN ; Keon Jung LEE ; Seung Hwan LEE ; Seok Hyun CHO ; Kyung Rae KIM ; Jin Hyeok JEONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2011;54(3):197-202
BACKGROUND AND OBJECTIVES: Nitric oxide (NO) is present in high concentrations in the upper respiratory tract. The physiological role of this mediator is to contribute to the local host's defense, modulate ciliary motility and serve as an aerocrine mediator in helping to maintain adequate ventilation-perfusion matching in the lung. SUBJECTS AND METHOD: The purpose of the study was to assess the relationship of nasal NO (nNO) and exhaled NO (eNO) in nasal airway disease patients. NO concentration was measured using a chemiluminescence analyzer. nNO was analyzed by aspiration at a sampling flow rate of 700 mL/min with velum closure. eNO was analyzed during expiration against a constant resistance of 10 cm H2O. RESULTS: NO concentration of the normal control group (n=32) was compared with that of the allergic rhinitis group (n=31) and the rhinosinusitis with that of the nasal polyp group (n=30). The mean nNO level in the control group was 241+/-89 ppb and eNO was 20.5+/-6.4 ppb. The mean nNO level was significantly increased in the allergic rhinitis group (332+/-125 ppb) but decreased in the chronic sinusitis group (89+/-55 ppb). The mean eNO level was significantly increased both in the allergic rhinitis group (26.9+/-10.1 ppb) and chronic sinusitis group (29.8+/-12.8 ppb). CONCLUSION: nNO concentration was increased in patients with allergic rhinitis and decreased in patients with chronic sinusitis; however, eNO was increased in both patients. This shows that patients with upper respiratory inflammation may also have lower respiratory inflammation, supporting the concept of 'one airway, one disease'. This study shows that measurement of NO is useful for the study or evaluation of nasal diseases.
Humans
;
Inflammation
;
Luminescence
;
Nasal Polyps
;
Nitric Oxide
;
Nose Diseases
;
Respiratory System
;
Rhinitis
;
Rhinitis, Allergic, Perennial
;
Sinusitis
4.The Effect of Radiation Therapy on Paranasal Sinus Opacification in Nasopharyngeal Cancer Patients.
Hyo Jin PARK ; Jae Ho KIM ; Jin Seok YANG ; Suk Woo LEE
Journal of Rhinology 2003;10(1, 2):10-13
BACKGROUND AND OBJECTIVES: Previous studies have reported that irradiation influences mucociliary clearance by damaging ciliary motility in respiratory mucosa. The purpose of this study is to investigate the effect of radiotherapy (RT) on opacification of paranasal sinuses in patients with nasopharyngeal carcinoma, and to find out what kind of influence anatomic variations such as nasal septal deviation or concha bullosa may have on the pathogenesis of sinus opacification. MATERIALS AND METHODS: Subjects were 26 patients (19 males and 7 females, aged 23 to 69) of early nasopharyngeal carcinoma (T1, T2) who were treated with RT between 1989 and 1999. Pre-RT and post-RT Computerized Tomography (CT) and medical records were reviewed retrospectively. The mean radiation dosage was 6965 cGy and mean follow-up period was 30 months (6 months to 7 yeas 1 month). Eighteen patients had nasal septal deviation and 9 patients had nasal septal deviation with concha bullosa. A total of 52 maxillary sinuses and 52 ethmoid sinus sides were analyzed. RESULTS: In 15 (57.7%) of 26 patients, opacifications of sinuses were newly developed or were aggravated after RT. The prevalence of aggravated sinus opacification according to anatomic variations was as follows : 30.8% in no anatomic variations, 32.1% in the concave side of nasal septal deviation, 36.8% in the convex side of nasal septal deviation, 42.9% in the concave side of nasal septal deviation with concha bullosa, and 68.8% in the convex side of septal deviation with concha bullosa. There was a significant difference in sinus opacification between sinuses without variations and sinuses with septal deviations combined with concha bullosa (p<0.05). CONCLUSION: These data suggest that irradiation of the nasopharynx may induce or aggravate paranasal sinusitis, and anatomic variations such as nasal septal deviation or concha bullosa may contribute to the pathogenesis of sinusitis.
Ethmoid Sinus
;
Female
;
Follow-Up Studies
;
Humans
;
Male
;
Maxillary Sinus
;
Medical Records
;
Mucociliary Clearance
;
Nasopharyngeal Neoplasms*
;
Nasopharynx
;
Paranasal Sinus Diseases
;
Paranasal Sinuses
;
Prevalence
;
Radiation Dosage
;
Radiotherapy
;
Respiratory Mucosa
;
Retrospective Studies
;
Sinusitis
6.Postnasal Drip Syndrome.
Journal of Rhinology 2011;18(1):16-19
Postnasal drip syndrome is one of the most common causes of chronic cough, and is caused by a variety of conditions including vasomotor rhinitis, allergic rhinitis, nasal polyps and chronic sinusitis. Postnasal drip syndrome is diagnosed based on clinical symptoms, and patients may complain of tickles or drainage of liquid in the back of the throat. Cobblestoning of the nasal or oropharyngeal mucosa may be observed upon physical examination. However, in many patients cough may be the only symptom of postnasal drip syndrome. Confirmation of the diagnosis may depend on the resolution of symptoms after treatments with antihistamines and intranasal or systemic corticosteroids.
Adrenal Cortex Hormones
;
Cough
;
Drainage
;
Histamine Antagonists
;
Humans
;
Mucous Membrane
;
Nasal Polyps
;
Pharynx
;
Physical Examination
;
Rhinitis
;
Rhinitis, Allergic, Perennial
;
Rhinitis, Vasomotor
;
Sinusitis
7.Recent Developments in United Airways Disease.
Giorgio CIPRANDI ; Davide CAIMMI ; Michele MIRAGLIA DEL GIUDICE ; Mario LA ROSA ; Carmelo SALPIETRO ; Gian Luigi MARSEGLIA
Allergy, Asthma & Immunology Research 2012;4(4):171-177
The nose and lung are both part of the respiratory tract. Often the diseases affecting the nose and/or the bronchi are treated separately. However, in recent years, numerous studies have highlighted the fact that the respiratory system is a single entity and the concept of "united airway disease" has become more and more important. The unity of the respiratory tract is confirmed both from a morphological and from a functional point of view. Nevertheless, this concept is also confirmed for the respiratory immune system, innervation and vascularization interesting all along the tract, from the nose to the bronchioles. When treating rhinitis, it is often necessary to assess the presence of asthma. Patients with sinusitis should be evaluated for a possible concomitant asthma. Conversely, patients with asthma should always be evaluated for possible nasal disease. The medications that treat nasal diseases appear to be useful in improving control of asthma and in reducing bronchial hyperresponsiveness as well. Physicians should always keep these notions in mind, and evaluate and treat respiratory diseases taking into account the unity of the respiratory tract.
Asthma
;
Bronchi
;
Bronchioles
;
Humans
;
Immune System
;
Lung
;
Nose
;
Nose Diseases
;
Respiratory System
;
Rhinitis
;
Rhinitis, Allergic, Perennial
;
Sinusitis
8.Long-Term Results of Laser Surgery for Nasal Hyper-Reactivity.
Tae Young JANG ; Yong Sun JEON ; Yoon Seok CHOI ; Sung Ho HWANG
Korean Journal of Otolaryngology - Head and Neck Surgery 2004;47(4):335-339
BACKGROUND AND OBJECTIVES: Laser vaporization on the inferior turbinate can be an valuable surgical method with safety, less morbidity and good efficacy. However, long term results are not exactly known. Furthermore, concrete data for success rates using different laser techniques is not available yet. The aim of this study is to evaluate the long-term result of laser surgery using different laser technique in patients with hypersensitive nasal diseases. SUBJECTS AND METHOD: We retrospectively reviewed 53 cases which had been treated with CO2 laser and followed up for more than 3 years. The subjects consisted of 29 patients with allergic rhinitis and 24 patients with vasomotor rhinitis. Laser surgical techniques were divided into two groups;vaporization of only inferior turbinate (conventional group) and inferior turbinate, upper septum, middle turbinate, agger nasi (extended group). Changes in the degree of nasal obstruction, watery rhinorrhea, sneezing were compared postoperatively between the two surgical procedure, and two different diseases. RESULTS: Long-term result (67%) was slightly lower than short-term result (69%). There was no difference in the success rates (68%) for both laser and surgical technique. Patients with vasomotor rhinitis (75%) showed better success rate than with allergic rhinitis (62%). Rate of success was better in the extended group than in the conventional group for watery rhinorrhea and sneezing. CONCLUSION: Success rate of laser surgery performed at Inha university hospital was 68%. The extended technique was more effective than the conventional technique for short-term result. However, there was no difference in the long-term results using different laser techniques.
Humans
;
Laser Therapy*
;
Lasers, Gas
;
Nasal Obstruction
;
Nose Diseases
;
Retrospective Studies
;
Rhinitis
;
Rhinitis, Vasomotor
;
Sneezing
;
Turbinates
9.The Present State of Korean Traditional Medicine and Alternative Medicine in Nasal Disease.
Joo Hyun JUNG ; Jung Ho LEE ; Il Gyu KANG ; Heung Eog CHA ; Seon Tae KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2010;53(1):12-19
BACKGROUND AND OBJECTIVES: Alternative medicine is becoming increasingly popular and is frequently used for treating patients with nasal diseases. While western medicine and operative treatment are proven treatments, herbal medicine and alternative medicine are widely used without any supporting evidence for treating cases of allergic rhinitis, sinusitis and hypertrophic rhinitis. So, we have tried to assess the present state of Korean traditional medicine (KTM) and alternative medicine for treating nasal cavity diseases. MATERIALS AND METHOD: We surveyed 204 patients who visited our department and were diagnosed with allergic rhinitis, sinusitis, deviated septum and/or hypertrophic rhinitis. The questionnaire included questions about whether or not the patients had tried KTM or alternative medicine, the reason for using KTM or alternative medicine, the frequency, kind, duration, effectiveness, cost and satisfaction and side effects. RESULTS: Among 204 patients, 14% of the patients had used KTM and 18% of the patients had used alternative medicine. The percent of those who had used KTM or alternative medicine in each of the allergic rhinitis patient, the sinusitis patient and the deviated septum with hypertrophic rhinitis patient groups were 46, 41, and 24%, respectively. The satisfaction rate for KTM was 47% and that for alternative medicine was 40%. The satisfaction rate for western medicine was higher than that for KTM and alternative medicine. CONCLUSION: Many patients used non-western medicine with obscure expectations. However, KTM and alternative medicine are not evidence-based treatments, so further research and education for patients are needed.
Complementary Therapies
;
Cost-Benefit Analysis
;
Herbal Medicine
;
Humans
;
Medicine, Korean Traditional
;
Nasal Cavity
;
Nose Diseases
;
Surveys and Questionnaires
;
Rhinitis
;
Rhinitis, Allergic, Perennial
;
Sinusitis
10.The expression of serum IL-10,12,13,16 in patients with allergic rhinitis and vasomotor rhinitis.
Jianjun CHEN ; Weijia KONG ; Yue ZHOU ; Jisheng XIANG ; Hong SHU ; Qiumei SHI ; Huifang TAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2007;21(20):913-915
OBJECTIVE:
To study the role of serum IL-10, 12, 13, 16 in patients with allergic rhinitis and vasomotor rhinitis.
METHOD:
The serum levels of IL-10, 12, 13, 16 were measured by ELISA in 30 cases of allergic rhinitis, 25 cases of vasomotor rhinitis and 20 healthy people.
RESULT:
The level of IL-12 in allergic rhinitis was (170.33 +/- 90.58) ng/L, which was significantly lower than that of normal controls [(376.69 +/- 140.70) ng/L, P < 0.01]. The levels of IL-13 and IL-16 in allergic rhinitis were (408.51 +/- 189.68) ng/L and (151.53 +/- 63.56) ng/L, which were significantly higher than those of normal controls [(151.92 +/- 85.08) ng/L, (60.65 +/- 32.45) ng/L, P < 0.01]. There were no significant difference of levels of IL-10, 13, 16 between vasomotor rhinitis and normal controls, while the level of IL-12 in vasomotor rhinitis was lower than that of normal controls [(196.03 +/- 96.31) ng/L vs. (376.69 +/- 140.70) ng/L, P < 0.01]. It was suggested that IL-10 had positive correlation with IL-12 (r = 0.73, P < 0.01), and IL-13 had positive correlation with IL-16 (r = 0.94, P < 0.01).
CONCLUSION
The imbalance of IL-12, IL-13 and IL-16 play crucial roles of regulation in the onset and developing of allergic rhinitis. Further research is needed on the role of IL-12 in vasomotor rhinitis.
Adolescent
;
Adult
;
Case-Control Studies
;
Child
;
Child, Preschool
;
Female
;
Humans
;
Interleukin-10
;
blood
;
Interleukin-12
;
blood
;
Interleukin-13
;
blood
;
Interleukin-16
;
blood
;
Male
;
Middle Aged
;
Rhinitis, Allergic, Perennial
;
blood
;
Rhinitis, Allergic, Seasonal
;
blood
;
Rhinitis, Vasomotor
;
blood
;
Young Adult