title: Chapter 16: Determining the role of allergy in sinonasal disease.
abstract: The contributing role of specific IgE sensitization in the pathophysiology of sinonasal diseases including rhinitis, chronic rhinosinusitis (CRS), and nasal polyps is explored. Although it is estimated that sensitization to environmental allergens is present in 75% of patients with rhinitis, the role of allergy in CRS and nasal polyps is less certain. However, when atopy is present in the setting of nasal polyps, it is associated with worse quality of life and a higher incidence of asthma. Several theories have been put forth whereby inhalant aeroallergen exposure could drive the inflammatory response that occurs both in the nose and in the sinuses. Tools available to determine the presence of allergic sensitization include skin tests for immediate hypersensitivity, in vitro testing for allergen-specific IgE, and nasal allergen provocation testing. Whether by skin testing or in vitro testing, the identification of specific IgE requires clinical correlation with the history and physical exam.
authors.affiliation: Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. russell_settipane@brown.edu
authors.forename: Russell A
authors.initials: RA
authors.lastname: Settipane
authors.forename: Larry
authors.initials: L
authors.lastname: Borish
authors.forename: Anju T
authors.initials: AT
authors.lastname: Peters
mesh_terms: D000485:Allergens / Q000276:immunology; D002908:Chronic Disease; D004781:Environmental Exposure / Q000009:adverse effects; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000276:immunology*; D007114:Immunization; D007073:Immunoglobulin E / Q000276:immunology*; D009298:Nasal Polyps; D010256:Paranasal Sinuses / Q000276:immunology*; D011788:Quality of Life; D012220:Rhinitis / Q000150:complications / Q000276:immunology*; D012698:Serologic Tests; D012852:Sinusitis / Q000150:complications / Q000276:immunology*; D012882:Skin Tests
chemical_list: D000485:Allergens; D007073:Immunoglobulin E