Middle turbinate edema as a diagnostic marker of inhalant allergy

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

Research output: Contribution to journalArticle

13 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
JournalInternational Forum of Allergy and Rhinology
DOIs
Publication statusAccepted/In press - 2016

Fingerprint

Turbinates
Edema
Hypersensitivity
Nose
ROC Curve
Endoscopy
Sensitivity and Specificity
Nasal Cavity
Serology
Cross-Sectional Studies

Keywords

  • Allergic
  • Atopy
  • Endoscopy
  • Middle turbinate
  • Nasal polyp
  • Rhinitis
  • Turbinates

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Wan Hamizan, A. K., Christensen, J. M., Ebenzer, J., Oakley, G., Tattersall, J., Sacks, R., & Harvey, R. J. (Accepted/In press). Middle turbinate edema as a diagnostic marker of inhalant allergy. International Forum of Allergy and Rhinology. https://doi.org/10.1002/alr.21835

Middle turbinate edema as a diagnostic marker of inhalant allergy. / Wan Hamizan, Aneeza Khairiyah; Christensen, Jenna M.; Ebenzer, Jareen; Oakley, Gretchen; Tattersall, Jessica; Sacks, Raymond; Harvey, Richard J.

In: International Forum of Allergy and Rhinology, 2016.

Research output: Contribution to journalArticle

Wan Hamizan, Aneeza Khairiyah ; Christensen, Jenna M. ; Ebenzer, Jareen ; Oakley, Gretchen ; Tattersall, Jessica ; Sacks, Raymond ; Harvey, Richard J. / Middle turbinate edema as a diagnostic marker of inhalant allergy. In: International Forum of Allergy and Rhinology. 2016.
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