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Sinus CT scans and mediator release in nasal secretions after nasal challenge with cypress pollens
V Piette1, C Bousquet, V Kvedariene
1Maladies Respiratoires, INSERMU454, IFR3, Hôpital Arnaud de Villeneuve, CHU Montpellier, 34295 Montpellier Cedex 5, France.
Background:
Involvement of paranasal sinuses has been suggested in allergic rhinitis but not clearly demonstrated.
Aims:
To investigate the relationship between intermittent allergic rhinitis and computerized tomography (CT).
Methods:
Twenty patients with intermittent rhinitis and sensitized to cypress pollens underwent unilateral nasal provocation tests (NPTs) using increasing concentrations of cypress pollens out of the pollen season. Sinus CT-scans were carried out just before a NPT and 24 h later. Nasal lavage was carried out just before a NPT, 30 min after a positive challenge and again 24 h later. Leucotriene C4/D4, intracellular adhesion molecule-1 and eosinophil cationic protein were measured in nasal secretions.
Results:
Thirteen patients (65%) showed an alteration in their CT-scans after allergen challenge. Ten of them showed sinus changes controlateral to their allergenic provocation. Radiological changes mainly affected the osteomeatal complex and the ethmoid sinuses. Pre-existing abnormalities (13 of 20 cases) mainly concerned the maxillary sinuses. There was no correlation between CT-scan abnormalities and levels of mediators released in nasal secretions.
Conclusions:
We have shown that nasal allergen challenge can produce radiological changes in the paranasal sinuses. This mainly concerned the ethmoid sinuses.
