Can an otorhinolaryngological visit induce the suspect of allergic rhinitis in children?

Abstract

Allergic rhinitis (AR) is very frequent in childhood. AR is commonly associated with some co-morbidities and typical clinical features. This study aimed to test the hypothesis whether an otorhinolaryngological (ORL) visit could induce the suspect of AR. Globally, 1,002 children (550 males, mean age 5.77 years) were consecutively visited at an ORL clinic. Clinical visit, nasal endoscopy, and skin prick test were performed in all patients. In particular, history investigated atopic familiarity, birth, feeding type, passive smoking, comorbidities, including asthma, respiratory infections, otitis media, respiratory sleep disorder. Endoscopy assessed the tonsil and adenoid volume, turbinate contacts, mucosal color, and nasal discharge. Univariate and multivariate analysis were performed. The study showed that 547 (54.6%) children had AR. Some parameters were predicting factor for suspecting AR: middle turbinate contact (OR=9.27), familial atopy (OR=6.24), pale nasal mucosa (OR=4.95), large adenoid volume (OR=3.02 for score 4), and asthma co-morbidity (OR=2.95). In conclusion this real-life study showed that during an ORL visit it is possible to suspect AR in children with turbinate hypertrophy, familial atopy, nasal pale mucosa, adenoid enlargement, and asthma comorbidity.

Features of inhalant allergy on nasal endoscopy: a systematic review and meta-analysis

“…Abstract screening was performed on 410 records. Full-text analysis was performed on 133 articles (2 full-text's were unable to be located) resulting in 15 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) studies being included (Figure 1).…”

“…A median of 187 participants were recruited per study (minimum 40, maximum 1322). Of the 15 included studies, 11 included a strictly pediatric population (<18 years) (10)(11)(12)(13)(14)16,17,19,(22)(23)(24) , 2 included a strictly adult population (≥18 years) (15,20) , 1 included a mixed pediatric and adult population (18) , and 1 did not mention if inclusion was restricted by age (21) .…”

“…All articles were original with cross-sectional study designs (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)24) , with the exception of two studies, 1 was a conference abstract with a cross-sectional design (23) , and the other an original article with a self-controlled case series design (10) .…”

“…Of the 15 included studies, 10 used SPT as their only reference standard (11)(12)(13)(14)(15)(16)(17)(22)(23)(24) , 1 used specific IgE serology as their only reference standard (20) , 3 used either SPT or specific IgE serology (18,19,21) , and 1 used SPT 'in season' as their reference standard (and had their same population 'out of season' as the control group as the study had a self-controlled case series design) (10) .…”

“…For the nasal endoscopy procedure, 8 studies stated that local anesthetic or decongestant was applied prior to endoscopy (11)(12)(13)16,(18)(19)(20)(21) , 1 stated that no local anesthetic or decongestant was used (22) , and 6 did not specify if local anesthetic or decongestant was used (10,14,15,17,23,24) . It was reported that endoscopy only took place during the allergy season in 4 studies (10,15,16,21) and not specified in the remaining 11 studies (11)(12)(13)(14)(17)(18)(19)(20)(22)(23)(24) .…”