The relationship between allergy and rhinosinusitis.

BACKGROUND

IgE-mediated hypersensitivity is considered by some to be a predisposing factor for developing rhinosinusitis, although the theory is still controversial. The purpose of this study was to evaluate the relationship between allergy and rhinosinusitis.

DESIGN

A cross-sectional study.

METHODS

198 rhinitis patients were enrolled. An allergy skin prick test was done and the subjects categorized as allergic or nonallergic. Nasal endoscopy and sinus radiography were performed. The criteria for diagnosis of rhinosinusitis were rhinitis symptoms and positive nasal endoscopy (discharge from middle and/or superior meatus) and/or abnormal sinus radiography.

RESULTS

Allergic patients were significantly more likely to have abnormal findings on sinus radiography than non-allergic patients (p < 0.001) and would therefore fulfill the criteria on which rhinosinusitis may be diagnosed, but the two groups were not significantly different in positive nasal endoscopy results (p = 0.553). Among the patients with abnormal sinus radiography, the allergic patients were significantly less likely to have a positive nasal endoscopy compared to the nonallergic patients (p = 0.006).

CONCLUSIONS

Allergic rhinitis subjects were significantly more likely to have abnormal findings on sinus radiography compared with nonallergic subjects potentially leading to a diagnosis of rhinosinusitis. However, they were also significantly more likely to have abnormal sinus radiography with negative nasal endoscopy than the nonallergic subject. These findings could suggest an association between allergic rhinitis and rhinosinusitis via IgE mediated hypersensitivity.