Insufficiency of Laboratory Data in Reflecting Allergic Rhinitis Severity Based on the Allergic Rhinitis and Its Impact on Asthma Guideline in Korean Patients

Background and Objectives@#This retrospective study, conducted at a single tertiary medical center, aimed to investigate the correlation between the severity of allergic rhinitis (AR) based on subjective symptoms and the severity assessed through laboratory data. @*Methods@#In total, 584 patients who were diagnosed with AR by a multiple-allergen simultaneous test were included. Patients were classified into four groups according to the Allergic Rhinitis and its Impact on Asthma (ARIA) classification guideline. The visual analog scale (VAS) score for overall discomfort and laboratory parameters, including the serum total immunoglobulin E (IgE) level and peripheral blood eosinophil count, were evaluated in all patients. An analysis was conducted to examine the differences in VAS scores and laboratory findings among the four groups. Additionally, the correlations between the laboratory findings and VAS score were analyzed. @*Results@#The serum total IgE level and the percentage and count of peripheral blood eosinophils showed no significant differences among the groups. However, the VAS score for overall discomfort exhibited notable between-group differences. The average VAS score was 6.14 (95% confidence interval 5.94–6.34) in the overall group. The mean scores of each group showed a noticeable increasing trend from the mild intermittent group to the mild persistent, moderate to severe intermittent, and moderate to severe persistent groups (p<0.001), although there was no clear correlation between the increase in VAS scores and laboratory parameters. @*Conclusion@#Neither the symptom-based ARIA guideline nor the VAS score correlated with the AR laboratory test measurements. The current laboratory data alone may not be sufficient to reflect the severity of AR based on subjective symptoms.

Simultaneous Treatment of Vestibular Schwannoma and Concurrent Middle Ear Disease Using the Enlarged Translabyrinthine Approach / 대한이비인후과학회지

Unilateral presentation of vestibular schwannoma with concurrent chronic middle ear disease or cholesteatoma is rare. We report a series of patients with ipsilateral chronic middle ear disease and vestibular schwannoma, which were simultaneously removed via the enlarged translabyrinthine approach. All tumors were near-totally removed, and middle ear disease was completely excised; there were no major postoperative complications such as cerebrospinal fluid leakage, cholesteatoma recurrence, or meningitis. If hearing preservation of the affected ear is not necessary, simultaneous surgical removal of both pathologies is more convenient than staged treatment. The enlarged translabyrinthine approach can achieve complete treatment with one corridor.