title: Middle turbinate edema as a diagnostic marker of inhalant allergy.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  Middle turbinate edema is a useful nasal endoscopic feature to predict presence of inhalant allergy and, although not sensitive, has excellent PPV.
authors.affiliation: Rhinology and Skull Base Research Group, St. Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia.|Department of Otolaryngology-Head and Neck Surgery, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Aneeza W
authors.initials: AW
authors.lastname: Hamizan
authors.affiliation: Rhinology and Skull Base Research Group, St. Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Jenna M
authors.initials: JM
authors.lastname: Christensen
authors.affiliation: Rhinology and Skull Base Research Group, St. Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Jareen
authors.initials: J
authors.lastname: Ebenzer
authors.affiliation: Rhinology and Skull Base Research Group, St. Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Gretchen
authors.initials: G
authors.lastname: Oakley
authors.affiliation: Rhinology and Skull Base Research Group, St. Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Tattersall
authors.affiliation: Australian School of Advanced Medicine, Macquarie University, Sydney, Australia.|Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, Sydney, NSW, Australia.
authors.forename: Raymond
authors.initials: R
authors.lastname: Sacks
authors.affiliation: Rhinology and Skull Base Research Group, St. Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia.|Australian School of Advanced Medicine, Macquarie University, Sydney, Australia.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Harvey
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology; D004487:Edema / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D004724:Endoscopy; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology; D012220:Rhinitis / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D012882:Skin Tests; D014420:Turbinates / Q000473:pathology*; D055815:Young Adult
chemical_list: D000485:Allergens
keywords: allergic; atopy; endoscopy; middle turbinate; nasal polyp; rhinitis; turbinates