Inflammation of the central nose considering variant anatomy in respiratory allergy

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. © 2022, Meditsina-Inform LLC. All rights reserved.