Predictive fiberoptic endoscopic findings of upper airway in children with allergic rhinitis

Karabulut, Burak; Sahin-Onder, Serap; Erkmen, Burak; Çetemen, Ayşen; Gergin, Özgül

doi:10.1016/j.ijporl.2019.06.004

Cited by 6 publications

(8 citation statements)

References 15 publications

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“…However, it has to be underlined that nasal fibreoptic endoscopy is the gold standard diagnostic tool in the management of all UA disorders. At present, endoscopy is a mandatory and unavoidable step in the ORL workup as it gives unique information about the anatomy and morphology of UA [109].…”

Section: Pragmatic Work-upmentioning

confidence: 99%

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

Varricchio¹,

Mantia

Brunese³

et al. 2020

Ital J Pediatr

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The upper airways (UA) should be considered as a functional unit. Current functional anatomy divides URT in three, mutually dependent, "junction boxes": i) the ostio-meatal complex (OMC), ii) the spheno-ethmoidal recess (SER), and iii) the rhinopharynx (RP). Correct ventilation and effective mucociliary clearance of these sites significantly affect the healthy physiology of the entire respiratory system. The OMC, SER, and RP obstruction is the first pathogenic step in the inflammatory/infectious cascade of UA disorders. The inflammation of the respiratory mucosa is the main pathogenic factor for airway obstruction. Moreover, bacterial biofilm (a strategy modality of bacterial survival) is an important local cause of systemic antibiotic ineffectiveness, recurrent infections, and antibiotic resistance. Health microbiota guarantees UA wellness; on the contrary, dysbiosis promotes and worsens UA infections. Allergy, namely type 2 inflammation, is a common cause of UA obstruction such as promoting in turn infections. Fiberoptic endoscopy is a mandatory diagnostic tool in clinical practice. Nasal cytology, mainly concerning flow cytometry, allows defining rhinitis phenotypes so allowing a precision medicine approach. Several conventional therapeutic approaches are available, but efficacy and safety should be ever properly considered before the prescription. Also, complementary medicine plays a fruitful role in the management of UA diseases. National and real-world studies are reported and discussed as they may be useful in daily clinical practice.

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Section: Pragmatic Work-upmentioning

confidence: 99%

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

Varricchio¹,

Mantia

Brunese³

et al. 2020

Ital J Pediatr

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“…The interrater reliability of middle turbinate hypertrophy was found to be substantial by one study (34) . The inter-rater reliability of grading adenoid hypertrophy by endoscopy has been previously discussed in the literature with mixed reports on its reliability (36)(37)(38)(39) ranging from fair (35) to substantial (34) . Another consideration is the type of endoscope used (flexible vs rigid).…”

Section: O R R E C T E D P R O O Fmentioning

confidence: 95%

“…Several studies have reported poor inter-rater reliability for various endoscopic findings. The inter-rater reliability of inferior turbinate hypertrophy has been reported in the literature as fair (15) to substantial (34) , whereas posterior turbinate hypertrophy (inferior) has been reported as poor (34,35) to moderate (15) . The interrater reliability of middle turbinate hypertrophy was found to be substantial by one study (34) .…”

Section: O R R E C T E D P R O O Fmentioning

confidence: 99%

“…The inter-rater reliability of inferior turbinate hypertrophy has been reported in the literature as fair (15) to substantial (34) , whereas posterior turbinate hypertrophy (inferior) has been reported as poor (34,35) to moderate (15) . The interrater reliability of middle turbinate hypertrophy was found to be substantial by one study (34) . The inter-rater reliability of grading adenoid hypertrophy by endoscopy has been previously discussed in the literature with mixed reports on its reliability (36)(37)(38)(39) ranging from fair (35) to substantial (34) .…”

Section: O R R E C T E D P R O O Fmentioning

confidence: 99%

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

Wegrecki¹,

Alvarado²,

Campbell³

et al. 2022

Rhin

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Background: Nasal endoscopy is increasingly accessible to ENT surgeons. The characteristics of the allergic upper airway are not well recognised. Methodology: MEDLINE (1946-2021), EMBASE (1974-2021), and the Cochrane Library were searched on 16th November 2021 to identify articles that reported endoscopic findings of patients with documented allergy who had undergone nasal endoscopy. The review followed the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. Meta-analysis was performed by pooling sensitivities and specificities using the hierarchical summary receiver operating characteristics model. Results: A total of 4108 articles were identified, of which 15 manuscripts met the inclusion criteria. The included studies involved 4660 patients who had undergone nasal endoscopy. Middle turbinate (diffuse/polypoid) oedema (sensitivity 58.0%, specificity 84.5%), watery secretions (sensitivity 65.7%, specificity 76.5%), inferior turbinate hypertrophy (sensitivity 86.2%, specificity 32.2%), and unspecified turbinate hypertrophy (sensitivity 82.0%, specificity 42.9%) were identified as the features with the highest predictive value of inhalant allergy. Conclusions: Diffuse or polypoid oedema of the middle turbinate or watery secretions seen on nasal endoscopy can be a useful adjunct in the identification and diagnosis of inhalant allergy. These clinical features should be part of the diagnostic workup for patients that includes a clinical history and surrogate markers of allergic sensitisation from the skin and serum.

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“…In two additional studies, children referred from allergy practices were assessed for both AH with nasal endoscopy and SPT sensitivity. Both studies excluded children on allergy medication and observed a significant negative correlation between AH and SPT positivity ( r = −0.208, p = 0.009) 3145 and ( p = 0.04) 3146 . The variability in study population recruitment and age range may explain the mixed findings.…”

Section: Associated Conditionsmentioning

confidence: 97%

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Wise

Damask

Roland

et al. 2023

Int Forum Allergy Rhinol

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Background In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR‐Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR‐Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence‐based findings and recommendation from the full document. Methods ICAR‐Allergic Rhinitis 2023 employed established evidence‐based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. Results ICAR‐Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. Conclusion The ICAR‐Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.

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Predictive fiberoptic endoscopic findings of upper airway in children with allergic rhinitis

Cited by 6 publications

References 15 publications

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

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

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

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