Middle turbinate edema as a diagnostic marker of inhalant allergy

Aneeza W. Hamizan*, Jenna M. Christensen, Jareen Ebenzer, Gretchen Oakley, Jessica Tattersall, Raymond Sacks, Richard J. Harvey

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    28 Citations (Scopus)

    Abstract

    Background: Middle turbinate edema could be a characteristic feature of aeroallergen sensitization. In this study we sought to determine the diagnostic characteristics of middle turbinate edema as a marker of inhalant allergy. Methods: A cross-sectional diagnostic study was performed on patients who had undergone nasal endoscopy and allergy testing. Allergy status was determined by positive serology or epicutaneous testing. Endoscopy was reviewed by blinded assessors for middle turbinate head edema. Appearance was graded as either normal, focal, multifocal, diffuse, or polypoid edema. Receiver-operator (ROC) analysis, likelihood ratio (LR), sensitivity, specificity, and positive predictive value (PPV) were determined. Results: One hundred eighty-seven patients representing 304 nasal cavities were assessed (42% female, age 39.74 ± 14.7 years, 57% allergic). Diffuse edema (PPV 91.7%/LR = 8) and polypoid edema (PPV 88.9%/LR = 6.2) demonstrated the strongest association with inhalant allergy. Multifocal edema was used as a cut-off to represent inhalant allergy from ROC analysis, which demonstrated 94.7% specificity and 23.4% sensitivity. The PPV for multifocal was 85.1% and LR = 4.4. Conclusion: Middle turbinate edema is a useful nasal endoscopic feature to predict presence of inhalant allergy and, although not sensitive, has excellent PPV.

    Original languageEnglish
    Pages (from-to)37-42
    Number of pages6
    JournalInternational Forum of Allergy and Rhinology
    Volume7
    Issue number1
    DOIs
    Publication statusPublished - Jan 2017

    Keywords

    • allergic
    • atopy
    • endoscopy
    • middle turbinate
    • nasal polyp
    • rhinitis
    • turbinates

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