ABSTRACT
The nasal allergen challenge has been widely used in studying allergic rhinitis. A number of factors and limitations are involved, however, they are rarely reported in perennial allergic rhinitis patients. This report is a sub-analysis from our routine challenges of 44 patients with perennial allergic rhinitis, who are allergic to house dust mites-the most common allergen in Thailand. We described the subjective and objective (i.e. rhinomanometry) responses after house dust mite provocation and addressed the factors involved in nasal responses. The patients underwent a serial challenge with mixtures of Dermatophagoides pteronyssinus and Dermatophagoides farinae by the disc method. The discs were placed bilaterally at 10-min intervals onto nasal mucosa. Just before the next provocation, the individual symptoms, total symptom score, and nasal airway resistance were assessed. All symptoms, nasal airway resistance and nasal airflow were altered in a dose-dependent manner. The concentration that produced significant discrepancy from the baseline was 50 AU/mL for congestion and pruritus, and 100 AU/mL for rhinorrhea and sneezing. Clinical symptoms following the allergen challenge increased in accordance with wheal size to the antigens, Dermatophagoides pteronyssinus in particular (p=0.03) and disease severity (p=0.03). Increase in nasal airway resistance agreed with the congestion score (p=0.001), total nasal symptoms score (p=0.008), skin reactivity (p
ABSTRACT
Solitary infection of the sphenoid sinus is an uncommon condition. A series of 13 patients with isolated sphenoid sinusitis was reported. A retrospective chart review was performed with special attention given to patients who presented signs, symptoms, culture results and radiographic findings. There were five patients with acute infection and eight with chronic infection. The predominant presenting symptoms were severe unexplained headache, cranial nerve palsies and visual impairment. Eight patients had underlying diseases. Computerized tomography and sinus endoscopy proved to be most useful diagnostic studies. Staphylococcus spp. and Gram negative organisms were responsible. Eleven patients were improved or cured. One patient died from septicemia. Early diagnosis and aggressive therapy, including surgical drainage, were important in preventing fatal complications and should not be delayed. Chiang Mai Med Bull 2545;41(1):1-6.