Endonasal Infrared Thermometry for the Diagnosis of Allergic Inflammation of the Nasal Mucosa in Patients with Bronchial Asthma

Abstract

Bronchial asthma (BA) is often associated with chronic inflammatory processes in the nasal mucosa; these processes give rise to allergic rhinitis, chronic rhinosinusitis, adenoiditis, and polypous rhinosinusitis. Due to their multiple symptoms, these diseases of the upper respiratory tract, especially allergic rhinitis, are often difficult to verify in patients with asthma. The aim of the study was to evaluate the diagnostic potential of endonasal IR thermometry in BA patients suspected of allergic rhinitis. Materials and Methods. Fifty children diagnosed with both BA and allergic rhinitis and 15 healthy children, matched by gender and age, participated in the study. The endonasal temperature determined with contactless IR thermometry was confronted with the symptoms of allergic rhinitis and sinusitis assessed with the TNSS and SNOT-20 questionnaires. The results were compared with the severity of nasal obstruction as determined through the anterior active rhinomanometry. Results. The nasal temperature in patients with asthma and allergic rhinitis was 33.77 [33.37; 34.17]°С, which was significantly lower than that in the group of healthy children (34.98 [34.57; 35.39]°С; p=0.0006); the body temperature did not differ between the groups (36.55 [36.45; 36.65] and 36.58 [36.40; 36.76]°С, respectively; p=0.5). We found a negative correlation between the values of nasal temperature and the sinusitis symptom scores in patients with BA and allergic rhinitis (R=-0.32; p=0.02). Conclusion. Patients with both BA and allergic rhinitis showed a decreased endonasal temperature in comparison with healthy children; the endonasal temperature can serve an indicator of allergic inflammation of the nasal mucosa.

Effect of Nasal Obstructive Disorders on Sinonasal Symptoms in Children with Different Levels of Bronchial Asthma Control

“…It was earlier indicated by Blaiss [ 18 ] and demonstrated in our recent studies [ 19 , 20 ] that AR can occur in all children with atopic asthma who have nasal symptoms. There is an opinion that the inflammatory process in the mucosa of the nasal cavity, including the process of allergic genesis, affects the mucosa of the paranasal sinuses.…”

Periostin as a Biomarker of Allergic Inflammation in Atopic Bronchial Asthma and Allergic Rhinitis (a Pilot Study)

“…All children underwent general clinical examination and assessment of susceptibility to antigens by detecting IgE antibodies or by skin tests to common allergens known to cause allergies in populations of the Volga-Vyatka region of Russia [ 39 ]. Routine examination of the ENT organs, rhino video endoscopy using flexible optics with 3.2 mm outer diameter (Atmos, Germany), as well as CT of the paranasal sinuses (when indicated) were performed [ 5 ]. The Total Nasal Symptom Score (TNSS) scale was used to assess the severity of the nasal symptoms [ 40 ].…”

“…The common pathogenetic mechanism of BA and allergic rhinitis/rhinosinusitis is allergic inflammation [ 1 , 5 , 6 ]. This may be associated with pathological remodeling of the respiratory tract, including the mucous membrane of the nose and paranasal sinuses [ 7 ].…”

Features of local inflammation of nasal mucosa in children with bronchial asthma

“…Предполагается, что температура в дыхательных путях также может служить маркером воспаления и ремоделирования слизистой оболочки у пациентов с аллергическими и иными воспалительными заболеваниями слизистой оболочки дыхательных путей, однако до настоящего времени изучению данных вопросов посвящены лишь единичные исследования [21,22]. При этом результаты исследований назальной температуры противоречивы даже при изучении когорты здоровых лиц [23,24].…”