Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey.
Department of Allergy and Immunology, Ege University School of Medicine, İzmir, Turkey.
Balkan Med J. 2017 Aug 4;34(4):318-322. doi: 10.4274/balkanmedj.2016.1339. Epub 2017 Apr 6.
Diagnosis of allergic rhinitis is primarily based on history, physical examination and allergy testing. A technique that noninvasively evaluates the soft tissue changes in the nasal mucosa of allergic rhinitis patients has not been defined.
To assess nasal mucosal changes and measure the submucosal fibrosis in allergic rhinitis patients with sonoelastography.
Case control study.
Eighty-eight turbinates of 44 patients were included in the study. There were 23 prick test positive allergic rhinitis patients. The control group constituted 21 patients. The rhinitis quality of life questionnaire and the visual analogue scale were applied to the allergic rhinitis patients. A higher visual analogue scale score indicated more severe allergic rhinitis symptoms. Sonoelastographic measurements were made from the lateral nasal wall. The propagation speed of sound waves was recorded in m/s. The presence of asthma and the type of allergic rhinitis (seasonal or perennial) was noted.
Ten patients had seasonal allergic rhinitis and thirteen patients had perennial allergic rhinitis. Six patients (26.1%) had accompanying asthma along with allergic rhinitis. The median visual analogue scale score was 7 (3-9) in allergic rhinitis patients. The median symptom duration was 7 (1-24) months. The median quality of life questionnaire score was 3.39 (1.68-5.43) points. The median sonoelastography scores of allergic rhinitis patients and healthy subjects were 2.38 m/s (0.9-4.47) and 2.42 m/s (1.62-3.50), respectively. Sonoelastographic measurements of seasonal and perennial allergic rhinitis patients did not differ significantly (p<0.05). The presence of asthma did not have a significant impact on the elastography measurements (<0.05). However, regression analysis revealed a significant inverse correlation (coefficients: B=0.005, standard error=0.097, beta 0=0.008) between the visual analogue scale and sonoelastography scores (p>0.05).
Sonoelastography was not suitable as a diagnostic tool in allergic rhinitis. Reduced sonoelastography scores were measured in more symptomatic patients. Higher visual analogue scale scores could be an indicator of disease severity.
过敏性鼻炎的诊断主要基于病史、体格检查和过敏测试。目前还没有一种无创技术可以评估过敏性鼻炎患者鼻黏膜的软组织变化。
使用超声弹性成像评估过敏性鼻炎患者的鼻黏膜变化并测量其黏膜下纤维化程度。
病例对照研究。
纳入了 44 例患者的 88 个鼻甲，其中 23 例为变应原皮试阳性的过敏性鼻炎患者，对照组由 21 例患者组成。对过敏性鼻炎患者应用鼻炎生活质量问卷和视觉模拟评分法（VAS）评估。VAS 评分越高表示过敏性鼻炎症状越严重。从鼻腔外侧壁进行超声弹性成像测量，以 m/s 记录声速传播速度。记录是否存在哮喘以及过敏性鼻炎的类型（季节性或常年性）。
10 例患者为季节性过敏性鼻炎，13 例为常年性过敏性鼻炎，6 例（26.1%）患者过敏性鼻炎合并哮喘。过敏性鼻炎患者的 VAS 评分中位数为 7（3-9）分，症状持续时间中位数为 7（1-24）个月，鼻炎生活质量问卷评分中位数为 3.39（1.68-5.43）分。过敏性鼻炎患者和健康受试者的超声弹性成像评分中位数分别为 2.38 m/s（0.9-4.47）和 2.42 m/s（1.62-3.50）。季节性和常年性过敏性鼻炎患者的超声弹性成像测量值无显著差异（p<0.05）。哮喘的存在对弹性成像测量值无显著影响（p<0.05）。然而，回归分析显示 VAS 评分与超声弹性成像评分之间存在显著的负相关（系数：B=0.005，标准误差=0.097，β 0=0.008，p>0.05）。
超声弹性成像不适用于过敏性鼻炎的诊断。在症状更严重的患者中，超声弹性成像评分较低。VAS 评分越高可能是疾病严重程度的指标。
