ADENOİD HİPERTROFİ VE EFFÜZYONLU OTİTİS MEDİA BİRLİKTELİĞİNDE ALERJİK RİNİTİN ETKİSİNİN ALERJİK RİNİT SEMPTOM SKORU (SFAR) İLE DEĞERLENDİRİLMESİ
Abstract
AMAÇ
Adenoid vejetasyon nedeniyle opere edilen hastalarda orta kulak patolojisi saptanmasında alerjik rinitin etkisi olup olmadığını SFAR kullanarak saptamaktır.
GEREÇ VE YÖNTEMLER
Bu çalışma adenoid hipertrofi nedeniyle 72 hastanın incelendiği retrospektif bir çalışmadır. 25 hastaya (Grup 1) Adenoidektomi+ventilasyon tüpü (VT) uygulaması, 47 hastaya (Grup 2) sadece Adenoidektomi uygulaması yapıldı. Adenoidektomi endikasyonu konulan hastalar yapılan fleksibl endoskopik muayenede nazofarinkste pasajı %70-100 arasında kapatan adenoid vejetasyonu saptanan hastalardan, VT uygulaması yapılan hastalar adenoid hipertrofi ile birlikte 3 aydan daha uzun süre aldığı tıbbi tedaviye rağmen gerilemeyen kronik effüzyonlu otitis mediaya (EOM) sahip hastalardan oluşmaktadır. Tüm hastaların değerlendirilmesi yapıldıktan sonra alerjik rinit semptom scoru (SFAR) kaydedildi. Grup 1 ve 2 hastalar SFAR değeri hesaplanarak karşılaştırıldı.
BULGULAR
Grup 1 ve Grup 2 hastalar SFAR ile alerji yönünden karşılaştırıldığında gruplar arasında istatistiksel olarak anlamlı bir farklılık saptanmamıştır. (p=0,150) Opere edilen hastalarda yaş ile birlikte alerjik rinit saptanması 7 yaşından büyük olan grupta istatistiksel olarak anlamlı artmıştır. (p=0,020) Cinsiyetin alerjik rinit saptanması üzerine etkisi saptanmamıştır. (p=0,829). Gruplar arasında SFAR değerlendirildiğinde Grup 1 ve 2 arasında istatistiksel olarak anlamlı değişiklik saptanmamıştır. (p=0,273) Grup 1 de ortalama SFAR 10,50 ±0,71 iken, Grup 2 de 9,00±2,16 saptanmıştır.
SONUÇ
Bu çalışmada adenoid hipertrofi ve adenoid hipertrofiye eşlik eden EOM lı hastaların SFAR kullanılarak karşılaştırılmasında alerjik rinitin etkisi olmadığı saptanmıştır. Ancak kesin bir yargıya varmak için arttırılmış hasta sayıları içeren, diagnostik invivo ve invitro testleri içeren prospektif çalışmalara ihtiyaç vardır.
References
- 1. Marseglia GL, Caimmi D, Pagella F, Matti E, Labó E, Licari A, et al. Adenoids during childhood: the facts. Int J Immunopathol Pharmacol 2011; 24: 1-5. 2. Ganzer U, Bachert C. Localization of Ig Esynthesis in immediate-type allergy of the upper respiratory tract. ORL J Otorhinolaryngol Relat Spec 1988; 50: 257-264. 3. Fireman P. Otitis media and eustachian tube dysfunction: Connection to allergic rhinitis. J Allergy Clin Immunol 1997; 99: 787Y97. 4. Stuar M. Late phase allergy and eustachian tube dysfunction. Oto-laryngol Head Neck Surg 2001; 125: 339Y45. 5. Doyle WJ. The link between allergic rhinitis and otitis media. Curr Opin Allergy Clin Immunol 2002; 2: 21Y5. 6. Zdenek Pelikan. Audiometric Changes in Chronic Secretory Otitis Media Due to Nasal Allergy. Otology & Neurotology 2009 Oct; 30(7): 868-75. 7. Alles R, Parikh A, Hawk L, Darby Y, Romero JN, Scadding G. The prevalence of atopic disorders in children with chronic otitis media with effusion. Pediatr Allergy Immunol 2001: 12: 102–106. 8. Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time-trends in the prevalence of symptoms of asthma, allergic rhinoconjuctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross sectional surveys. Lancet. 2006; 26: 733-743. 9. Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A et al. Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. Clin Exp Allergy 2012 Feb; 42(2): 186-207. 10. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA 2 LEN). Allergy. 2008; 63(suppl 86): 8-160. 11. Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J. The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies. 2002 Feb; 57(2): 107-14 Allergy. 12. Ologe FE, Adebola SO, Dunmade AD, Adeniji KA, Oyejola BA. Symptom score for allergic rhinitis. 2013 Apr; 148(4): 557-63 Otolaryngology –Head and neck surgery. 13. Griffin JL, Ramadan HH, Adham RE. Prevalance of IgE-mediated hypersensitivity in children with adenotonsillar disease. Arch Otolaryngol Head Neck Surg 1994; 120: 150-153. 14. Ameli F, Brocchetti F, Tosca MA, Signori A, Ciprandi G. Adenoidal hypertrophy and allergic rhinitis: is there aninverse relationship? Am J Rhinol Allergy 2013; 27: e5-10. 15. Modrzynski M, Zawisza E. An analysis of the incidenceof adenoid hypertrophy in allergic children. Int J Pediatr Otorhinolaryngol 2007; 71: 713-719. 16. Sadeghi-Shabestari M, Jabbari Moghaddam Y, Ghaharri H. Is there any correlation between allergy and adenotonsillar tissue hypertrophy? Int J Pediatr Otorhinolaryngol 2011; 75: 589-91. 17. Georgalas C, Thomas K, Owens C, Abramovich S, Lack G. Medical treatment for rhinosinusitis associated with adenoidal hypertrophy in children: an evaluation of clinical response and changes on magnetic resonance imaging. Ann Otol Rhinol Laryngol 2005; 8: 638-44. 18. Demirhan H, Aksoy F, Özturan O, Yıldırım S, Veyseller B. Medical treatment of adenoid hypertrophy with ‘‘fluticasone propionate nasal drops’’. Int J Pediatr Otorhinolaryngol 2010; 74: 773-6. 19. Saifudin N, Husaina S, Goha BS,. Prevalence of allergic rhinitis in children with otitis media with effusion Eur Ann Allergy Clin Immunol. 2019 Oct 31. 20. Caffarelli C, Savini E, Giordano S, Gianlupi G, Cavagni G. Atopy in children with otitis media with effusion. Clin Exp Allergy 1998; 28: 591-6.
EVALUATION OF THE EFFECT OF ALLERGIC RHINITIS ON ADENOID HYPERTROPHY AND OTITIS MEDIA WITH EFFUSION COMBINATION BY USING SCORE FOR ALLERGIC RHINITIS (SFAR)
Abstract
OBJECTIVE
The aim of this study is to determine whether allergic rhinitis exerts any effect on middle ear pathology in patients undergoing operation for adenoid vegetation by using SFAR.
MATERIAL AND METHODS
In this study 72 patients with adenoid vegetation were analyzed retrospectively. Twenty five patients (Group 1) underwent adenoidectomy and ventilation tube, while 47 patients (Group 2) underwent only adenoidectomy. Patients with adenoidectomy indications included those who were found to have 70-100% obstruction due to adenoid vegetation in nasopharynx via flexible endoscope, and patients undergoing VT included those who had intractable otitis media despite more than three months of treatment along with adenoid hypertrophy. SFAR was recorded after assessment of all the patients. Group 1 and Group 2 patients were compared using SFAR.
RESULTS
No statistically significant difference was found between Group 1 and Group 2 in terms of allergic rhinitis score measured by SFAR. (p=0,150) In the operated patient group, the rate of allergic rhinitis was significantly higher in those who are older than 7 years. (p=0,020) No impact of gender was found on the rate of allergic rhinitis. (p=0,829) No significant difference was found between Group 1 and Group 2 in the evaluation made with SFAR. (p=0,273) Mean SFAR score was found to be 10,500+0,71 in Group 1 and 9,00+2,16 in Group 2.
CONCLUSION
In this study no impact of allergic rhinitis on adenoid hypertrophy and adenoid hypertrophy accompanied with otitis media with effusion was found using SFAR. In order to reach a definitive conclusion, further studies with higher number of patients and which include prospective invivo and invitro tests are required.
References
- 1. Marseglia GL, Caimmi D, Pagella F, Matti E, Labó E, Licari A, et al. Adenoids during childhood: the facts. Int J Immunopathol Pharmacol 2011; 24: 1-5. 2. Ganzer U, Bachert C. Localization of Ig Esynthesis in immediate-type allergy of the upper respiratory tract. ORL J Otorhinolaryngol Relat Spec 1988; 50: 257-264. 3. Fireman P. Otitis media and eustachian tube dysfunction: Connection to allergic rhinitis. J Allergy Clin Immunol 1997; 99: 787Y97. 4. Stuar M. Late phase allergy and eustachian tube dysfunction. Oto-laryngol Head Neck Surg 2001; 125: 339Y45. 5. Doyle WJ. The link between allergic rhinitis and otitis media. Curr Opin Allergy Clin Immunol 2002; 2: 21Y5. 6. Zdenek Pelikan. Audiometric Changes in Chronic Secretory Otitis Media Due to Nasal Allergy. Otology & Neurotology 2009 Oct; 30(7): 868-75. 7. Alles R, Parikh A, Hawk L, Darby Y, Romero JN, Scadding G. The prevalence of atopic disorders in children with chronic otitis media with effusion. Pediatr Allergy Immunol 2001: 12: 102–106. 8. Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time-trends in the prevalence of symptoms of asthma, allergic rhinoconjuctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross sectional surveys. Lancet. 2006; 26: 733-743. 9. Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A et al. Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. Clin Exp Allergy 2012 Feb; 42(2): 186-207. 10. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA 2 LEN). Allergy. 2008; 63(suppl 86): 8-160. 11. Annesi-Maesano I, Didier A, Klossek M, Chanal I, Moreau D, Bousquet J. The score for allergic rhinitis (SFAR): a simple and valid assessment method in population studies. 2002 Feb; 57(2): 107-14 Allergy. 12. Ologe FE, Adebola SO, Dunmade AD, Adeniji KA, Oyejola BA. Symptom score for allergic rhinitis. 2013 Apr; 148(4): 557-63 Otolaryngology –Head and neck surgery. 13. Griffin JL, Ramadan HH, Adham RE. Prevalance of IgE-mediated hypersensitivity in children with adenotonsillar disease. Arch Otolaryngol Head Neck Surg 1994; 120: 150-153. 14. Ameli F, Brocchetti F, Tosca MA, Signori A, Ciprandi G. Adenoidal hypertrophy and allergic rhinitis: is there aninverse relationship? Am J Rhinol Allergy 2013; 27: e5-10. 15. Modrzynski M, Zawisza E. An analysis of the incidenceof adenoid hypertrophy in allergic children. Int J Pediatr Otorhinolaryngol 2007; 71: 713-719. 16. Sadeghi-Shabestari M, Jabbari Moghaddam Y, Ghaharri H. Is there any correlation between allergy and adenotonsillar tissue hypertrophy? Int J Pediatr Otorhinolaryngol 2011; 75: 589-91. 17. Georgalas C, Thomas K, Owens C, Abramovich S, Lack G. Medical treatment for rhinosinusitis associated with adenoidal hypertrophy in children: an evaluation of clinical response and changes on magnetic resonance imaging. Ann Otol Rhinol Laryngol 2005; 8: 638-44. 18. Demirhan H, Aksoy F, Özturan O, Yıldırım S, Veyseller B. Medical treatment of adenoid hypertrophy with ‘‘fluticasone propionate nasal drops’’. Int J Pediatr Otorhinolaryngol 2010; 74: 773-6. 19. Saifudin N, Husaina S, Goha BS,. Prevalence of allergic rhinitis in children with otitis media with effusion Eur Ann Allergy Clin Immunol. 2019 Oct 31. 20. Caffarelli C, Savini E, Giordano S, Gianlupi G, Cavagni G. Atopy in children with otitis media with effusion. Clin Exp Allergy 1998; 28: 591-6.
Details
| Primary Language | English |
|---|---|
| Subjects | Surgery |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Publication Date | March 18, 2020 |
| Submission Date | January 31, 2020 |
| Published in Issue | Year 2020 Volume: 14 Issue: 2 |
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