Prevalence of abnormalities found by sinus x-rays in childhood asthma: Lack of relation to severity of asthma

Zimmerman, Barry J.; Stringer, David A.; Feanny, Stephen; Reisman, Joseph; Hak, H.; Rashed, Nashed; deBenedictis, Fernando; McLaughlin, John M.; Levison, Henry

doi:10.1016/0091-6749(87)90029-7

Cited by 59 publications

(13 citation statements)

References 11 publications

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“…AR is a risk factor for sinusitis [3], and patients with BA are at increased risk for sinusitis [4, 5]. While some studies suggest that sinusitis is a risk factor for severe asthma [5, 6], others do not [7, 8]. The epidemiologic relation between sinusitis and asthma is however not well studied especially in eastern countries.…”

Section: Introductionmentioning

confidence: 99%

Asthma and Sinusitis: Association and Implication

Matsuno

Ono

Takenaka

et al. 2008

Int Arch Allergy Immunol

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Background: Sinusitis occurs frequently in asthmatic patients. Epidemiologic data on sinusitis and lower airway disease must be evaluated with caution because they are based mostly on symptoms and do not include nasal endoscopic or computed tomography (CT) findings. Clinical support and evidence for this association are lacking. We evaluated the impact of sinusitis on lower airway disease in patients with well-characterized asthma. Methods: Subjects (n = 188) completed a questionnaire designed to provide information about their signs and symptoms related to asthma, allergic rhinitis (AR) and sinus disease. Patients (n = 104) were divided into four groups based on the presence or absence of sinusitis and/or AR. Clinical findings were compared in asthma patients with and without diagnosed sinusitis, by an otorhinolaryngologist or based on sinus CT findings. Results: The prevalence of sinusitis in patients with asthma was 36.7%. Sinus CT scan abnormalities were detected in 66.3% of patients with asthma. The scans revealed abnormal opacity in 17.9% of asthmatic patients without a history of sinusitis. There was a significant correlation between the rate of asthma severity and sinus morphologic abnormalities in patients with and without sinusitis. In adult-onset asthma (≧16 years old), sinusitis frequently preceded asthma, whereas in non-adult-onset asthma (<16 years old) it preceded sinusitis. The complication rate of sinusitis in asthmatic patients was significantly higher in adult-onset asthma than in non-adult-onset asthma. Conclusions: Our findings suggest that bronchial asthma is closely related to sinusitis and the onset age of asthma is important when considering allergic disease frequency. Whether sinus disease directly affects the intensity of bronchial inflammation remains to be elucidated.

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Section: Introductionmentioning

confidence: 99%

Asthma and Sinusitis: Association and Implication

Matsuno

Ono

Takenaka

et al. 2008

Int Arch Allergy Immunol

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“…It has been suggested that air-fluid level and sinus opacification indicate infection of the PNS, whereas isolated mucosal thickening merely represents chronic allergic process. l , 2 We conclude that there is a high prevalence of radiological abnormalities of the PNS in patients of asthma with coexisting rhinitis. These can be attributed to allergy i.e.…”

Section: Resultsmentioning

confidence: 96%

Radiological Abnormalities of Paranasal Sinuses in Asthmatics with Rhinitis

Sircar

Karol

Bhatia

1995

American Journal of Rhinology

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A total of 114 patients with asthma and coexisting rhinitis were screened radiologically for abnormalities suggestive of paranasal sinus (PNS) disease. Wefound such radiological abnormalities in 87 (76.3%) patients. Of these, 79 (90.8%) had involvement of maxillary sinuses, 29 (33.3%) offrontal sinuses, and 8 (9.2%) of sphenoidal sinuses. Sixteen (18.4%) patients had single sinus involvement, none being that of sphenoidal sinuses. Wefound erect occipito-mental (Water's) view most useful for the radiological screening of the PNS. Significance of these findings and possible clinical implications are reviewed. Radiological evaluation of the PNS is suggested to select patients requiring evaluation for sinusitis. (AmericanJournal of Rhinology9, [99][100][101] 1995) R adiological abnormalities of the paranasal sinuses (PNS) have been observed in both asthma and rhinitiS. 1 -3 Some of these are thought to be caused by sinusitis, which has been implicated in exacerbations of asthma. 4 Because rhinitis is an important precipitating factor of sinusitis,5 we evaluated patients with asthma and coexisting rhinitis for radiological abnormalities suggestive of sinusitis.Routine radiological evaluation of the PNS is often limited to obtaining erect occipito-mental (Water's) view. However, this does not visualize the posterior group of sinuses. In this study we assessed the contribution of lateral view that visualizes the posterior group of sinuses in the overall assessment of PNS abnormalities in our patients.

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“…23,24 However, there is a great overlap between bacterial sinusitis and allergic rhinitis in the clinical symptoms and radiological signs. 25,26 This overlap could potentially lead to mistreatment with antibiotics of patients with allergic rhinitis. Controlled trials showed no effect of treatment with oral antibiotics on chronic sinusitis as defined by clinical criteria.…”

Section: Discussionmentioning

confidence: 98%

Etiology and Outcome of Childhood Chronic Cough Using a Simple Diagnostic Approach

Mehdi¹,

Weinberger²,

Abu-Hasan³

2005

Pediatric Asthma, Allergy & Immunology

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Chronic cough in children represents a diagnostic challenge. This study evaluates the outcomes of a simple diagnostic approach that uses a positive response to therapeutic trial of asthma with short course of oral steroids as a diagnostic test if history and physical examination indicate no other illnesses. Electronic records of initial evaluation and follow-up visits were reviewed for all patients presenting with chronic cough to a Pediatric Allergy and Pulmonary clinic between 1995 and 2001, where such diagnostic approach has been undertaken. If a patient was lost to follow up, a phone call was attempted to complete records. A total of 69 patients were eligible. Median age at presentation was 3 years (range 0.3-15). Final diagnosis was reached in 54 (75%) patients, 39 of which (72%) were confirmed to have asthma. Other diagnoses included gastroesophageal reflux in 3, pertussis in 3, airway malacia in 3, habit cough syndrome in 2, cystic fibrosis in 1, primary ciliary dyskinesia in 1, foreign body aspiration in 1, and Arnold-Chiari malformation in 1. Forty-four patients (80%) were given a different diagnosis from their pre-evaluation diagnosis. The average number of tests done on asthma patients was 2 and for non-asthma was 2.9. All asthma patients improved with treatment. Therapeutic trial with oral steroids is an effective tool in evaluating chronic cough to reach the diagnosis of asthma, resolve symptoms quickly, and minimize extensive testing.

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Prevalence of abnormalities found by sinus x-rays in childhood asthma: Lack of relation to severity of asthma

Cited by 59 publications

References 11 publications

Asthma and Sinusitis: Association and Implication

Asthma and Sinusitis: Association and Implication

Radiological Abnormalities of Paranasal Sinuses in Asthmatics with Rhinitis

Etiology and Outcome of Childhood Chronic Cough Using a Simple Diagnostic Approach

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