Correlation of total and specific serum immunoglobulin E levels with the severity of chronic sinusitis in children.

Chronic sinusitis is frequently associated with allergy and asthma. Previous studies have shown that serum immunoglobulin E (IgE) levels correlate with allergy and asthma in adults. Because the role of allergic inflammation in the severity of chronic sinusitis remains controversial in children, we set out to determine whether a correlation exists between serum levels of total and specific IgE and the severity of chronic sinusitis in children. Forty-four children with chronic sinusitis were enrolled in the study. Computed tomographic scans were reviewed and scored for the severity of sinusitis. All children were mite-sensitive. Serum samples were assayed for total IgE and specific IgE antibodies to mite allergen using a fluoroimmunoassay. Fourteen subjects had extensive sinus disease. There was no significant difference in the average of total and specific IgE between the subjects with extensive and limited disease (p = 0.562 and 0.755, respectively). Thirty-four subjects were diagnosed with asthma. The subjects with extensive sinus disease had a higher prevalence of moderate to severe asthma than the subjects with limited disease (p = 0.006), but there was no significant difference in the average of total and specific IgE between the subjects with different severities of asthma. (p = 0.833 and 0.425, respectively). The data suggests that levels of total or specific IgE do not correlate with severity of chronic sinusitis in children. Nonetheless, the severity of chronic sinusitis and asthma correlate well with each other irrespective of total and specific IgE.

Use of standard radiography to diagnose paranasal sinus disease of asthmatic children in Taiwan: comparison with computed tomography.

Paranasal sinus disease and bronchial asthma are frequently associated. Computed tomography imaging is currently the most reliable method for confirming the diagnosis of sinusitis. Due to the cost and amount of radiation during computed tomography, our aim was to analyze whether standard radiography, under computed tomography-control, had a reasonable degree of confidence in the diagnosis of sinusitis. Fifty-three asthmatic patients (42 males and 11 females) with a mean age of 9 years (range 4-14) were enrolled. We evaluated the maxillary sinuses, ethmoidal sinuses, frontal sinuses, and sphenoidal sinuses using standard radiography (Waters' view, Caldwell view, and lateral view) and compared with computed tomography (coronal views), the latter served as a standard. Computed tomography (CT) showed paranasal sinusitis in 58% (31/53) of the asthmatic children. Compared with the results of computed tomography, standard radiography revealed a sensitivity of 81.1% and a specificity of 72.7% for maxillary sinusitis. The sensitivity and specificity for ethmoidal, frontal, and sphenoidal sinusitis were 51.8%, 84.8%; 47.3%, 87.2%; and 40.8%, 93.3%, respectively. In 21 (40%) of the 53 patients, discrepancies were seen between the interpretations of standard radiography c and those of CT scans. In patients with maxillary sinusitis, the correlation between standard radiography and CT was good. However, ethmoidal, frontal, and sphenoidal sinusitis were poorly demonstrated using radiography. Standard radiography can be recommended as a screening method for maxillary sinusitis, but it is not recommended for the diagnosis of other paranasal sinusitis.