Inflammation of the central nose considering variant anatomy in respiratory allergy
DOI: 10.32364/2587-6821-2022-6-2-62-66
I.N. Grigorieva1,2, N.S. Tataurshchikova1, V.I. Popadyuk1, A.Yu. Sergeev3, P.V. Berezhanskiy1, A.S. Rusanova1, O.I. Letyaeva1, T.G. Fedoskova 1, A.A. Kameleva1, A.S. Korolev4
1Russian University of Peoples’ Friendship, Moscow, Russian Federation
2LLC "Institute of Allergy and Clinical Immunology", Moscow, Russian Federation
3Novosibirsk State University, Novosibirsk, Russian Federation
4MIREA Russian Technological University, Moscow, Russian Federation
Background: in respiratory allergy, a concept of a common respiratory epithelium of the nasal cavity and sinuses allows for a view from a different perspective on the changes of the ostiomeatal complex and central nose. In the individual anatomical variations of the nose, a relationship between the involvement of the ethmoidal labyrinth and the medial maxillary sinuses is suggested.
Aim: to assess the effect of variant anatomy on the course of inflammation in patients with respiratory allergy and clinical signs of allergic rhinitis (AR).
Patients and Methods: 15 patients (8 men and 7 women, mean age 42±13.2 years) with clinical signs of allergy were enrolled. All participants were divided into two groups. Group 1 (n=8) included patients with AR and the involvement of the ethmoidal labyrinth and medial maxillary sinuses. Group 2 (n=7) included patients with isolated AR (no sinus involvement). All patients underwent nasal and nasopharyngeal endoscopy. Respiratory allergen specific IgE screening panels (ImmunoCap, Phadia) were used to analyze sensitization profile. Sinus and nose anatomy was evaluated by computed tomography.
Results: a significant difference of nasal and sinus anatomy was found between the groups. A direct correlation between the deviated septum in its anterior and/or middle portions and inflammation of the ethmoidal labyrinth and central maxillary sinuses was identified. In addition, a weak inverse correlation between the deviated septum in its posterior parts and the inflammation of the central nose was identified. Finally, a tendency towards statistical significance for another anatomical trait, Haller’s cells, was revealed in group 1.
Conclusion: these findings should be considered when selecting the primary management strategy, i.e., surgery, allergen-specific immunotherapy or combination thereof.
Keywords: allergy, atopy, chronic rhinosinusitis, nasal polyposis, sinusitis, ethmoidal labyrinth, maxillary sinus.
For citation: Grigorieva I.N., Tataurshchikova N.S., Popadyuk V.I. et al. Inflammation of the central nose considering variant anatomy in respiratory allergy. Russian Medical Inquiry. 2022;6(2):62–66 (in Russ.). DOI: 10.32364/2587-6821-2022-6-2-62-66.
About the authors:
Irina N. Grigor’eva — C. Sc. (Med.), assistant of the Department of Clinical Immunology, Allergy, and Adaptation of the Faculty of Continuous Medical Education of the Medical Institute of the Russian University of Peoples’ Friendship; 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ENT specialist, LLC "Institute of the Allergy and Clinical Immunology"; 20, build. 1, Malaya Bronnaya str., Moscow, 123104, Russian Federation; ORCID iD 0000-0001-8412-2627.
Natalya S. Tataurshchikova — Dr. Sc. (Med.), Professor, Head of the Department of Clinical Immunology, Allergy, and Adaptation of the Faculty of Continuous Medical Education of the Medical Institute of the Russian University of Peoples’ Friendship; 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0002-3486-8188.
Valentin I. Popadyuk — Dr. Sc. (Med.), Head of the Department of Otorhinolaringology of the Medical Institute of the Russian University of Peoples’ Friendship; 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0003-3309-4683.
Alexey Yu. Sergeev — Dr. Sc. (Med.), professor of Center for Postgraduate Medical Education of the Novosibirsk State University; 1, Pirogov str., Novosibirsk, 630090, Russian Federation; ORCID iD 0000-0001-9061-1347.
Pavel V. Berezhanskiy — C. Sc. (Med.), assistant of the Department of Clinical Immunology, Allergy, and Adaptation
of the Faculty of Continuous Medical Education of the Medical Institute of the Russian University of Peoples’ Friendship; 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0001-5235-5303.
Anna S. Rusanova — specialist on educational and methodical work of the Department of Clinical Immunology, Allergy, and Adaptation of the Faculty of Continuous Medical Education of the Medical Institute of the Russian University of Peoples’ Friendship; 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0001-6574-1406.
Olga I. Letyaeva — Dr. Sc. (Med.), professor of the Department of Clinical Immunology, Allergy, and Adaptation of the Faculty of Continuous Medical Education of the Medical Institute of the Russian University of Peoples’ Friendship; 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0002-9085-6229.
Tatyana G. Fedoskova — Dr. Sc. (Med.), professor of the Department of Clinical Immunology, Allergy, and Adaptation of the Faculty of Continuous Medical Education of the Medical Institute of the Russian University of Peoples’ Friendship; 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0003-1456-3923.
Anastasiya A. Kameleva — C. Sc. (Med.), assistant of the Department of Clinical Immunology, Allergy, and Adaptation of the Faculty of Continuous Medical Education of the Medical Institute of the Russian University of Peoples’ Friendship; 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0002-5895-2982.
Anton S. Korolev — C. Sc. (Tech.), Associate Professor, Head of the Department of the Institute Artificial Intelligence, MIREA Russian Technological University; 78, Vernadskiy av., Moscow, 119454, Russian Federation; ORCID iD 0000-0001-8305-6066.
Contact information: Irina N. Grigorieva, e-mail: grigoryeva-in@rudn.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 20.01.2022.
Revised 14.02.2022.
Accepted 14.03.2022.
2. Orlandi R.R., Kingdom T.T., Smith T.L. et al. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol. 2021;11(3):213–739. DOI: 10.1002/alr.22741.
3. White L.J., Rotella M.R., DelGaudio J.M. Polypoid changes of the middle turbinate as an indicator of atopic disease. Int Forum Allergy Rhinol. 2014;4(5):376–380. DOI: 10.1002/alr.21290.
4. DelGaudio J.M., Loftus P.A., Hamizan A.W. et al. Central compartment atopic disease. Am J Rhinol Allergy. 2017;31(4):228–234. DOI: 10.2500/ajra.2017.31.4443.
5. Grayson J.W., Cavada M., Harvey R.J. Clinically relevant phenotypes in chronic rhinosinusitis. J Otolaryngol Head Neck Surg. 2019;48(1):23. DOI: 10.1186/s40463-019-0350-y.
6. Fokkens W.J., Lund V.J., Hopkins C. et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1–464. DOI: 10.4193/Rhin20.600.
7. Marcus S., Schertzer J., Roland L.T. et al. Central compartment atopic disease: prevalence of allergy and asthma compared with other subtypes of chronic rhinosinusitis with nasal polyps. Int Forum Allergy Rhinol. 2020;10(2):183–189. DOI: 10.1002/alr.22454.
8. Lin J., Kacker A. Management strategies for recurrent acute rhinosinusitis. Laryngoscope Investig Otolaryngol. 2019;4(4):379–382. DOI: 10.1002/lio2.294.
9. Veskitkul J., Vichyanond P., Pacharn P. et al. Clinical characteristics of recurrent acute rhinosinusitis in children. Asian Pac J Allergy Immunol. 2015;33(4):276–280. DOI: 10.12932/AP0591.33.4.2015.
10. Wise S.K., Lin S.Y., Toskala E. et al. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis. Int Forum Allergy Rhinol. 2018;8(2):108–352. DOI: 10.1002/alr.22073.
11. Scadding G., Lund V. Investigative rhinology. 1st ed. London: Taylor and Francis; 2004.
12. Marcus S., Roland L.T., DelGaudio J.M., Wise S.K. The relationship between allergy and chronic rhinosinusitis. Laryngoscope Investig Otolaryngol. 2018;4(1):13–17. DOI: 10.1002/lio2.236.
13. Рязанцев С.В., Будковая М.А., Артемьева Е.С. Дыхательная функция носа: современные подходы к диагностике и лечению патологических состояний. РМЖ. Медицинское обозрение. 2019;9(II):73–76. [Ryazantsev S.V., Budkovaya M.A., Artem’eva E.S. Nasal breathing: current diagnostic and treatment approaches. RMJ. Medical Review. 2019;9(II):73–76 (in Russ.)].
14. Saltagi M.Z., Comer B.T., Hughes S. et al. Diagnostic Criteria of Recurrent Acute Rhinosinusitis: A Systematic Review. Am J Rhinol Allergy. 2020;35(3):383–390. DOI: 10.1177/1945892420956871.
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