ORLANDO, Fla. — Rhinitis is a constellation of symptoms that are present in up to 40% of the pediatric population. However, until now, a validated objective measure to evaluate symptoms in pediatric patients did not exist.
Rhinitis is often complicated by asthma and includes symptoms of rhinorrhea, nasal congestion, sneezing, and itching. A study by Rekha Raveendran, MD, from the allergy/immunology division at Ohio State University Medical Center and Nationwide Children’s Hospital, Columbus, Ohio, reported here at the American Academy of Allergy, Asthma & Immunology 2012 Annual Meeting that two tests accurately detected independent parameters and can be useful in patient evaluation of rhinitis.
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Rekha
Raveendran
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Raveendran and colleagues recruited patients from a combined Allergy/Otolaryngology clinic where they were evaluated by a board certified allergist and a pediatric otolaryngologist. The 22-item Sino-Nasal Outcome Test (SNOT-22) was administered to patients, along with skin testing and acoustic rhinometry.
According to Raveendran, elevated symptom scores for waking up tired and congestion suggested severity of pediatric symptoms; total symptom scores did not distinguish patient groups (allergic, nonallergic or asthma). Post nasal drip was the only symptom that occurred more frequently in allergic patients rather than non allergic patients.
“All patients received a questionnaire to determine which symptoms correlated with their disease, and then we tried to use an objective measure like acoustic rhinometry to decide if there was a correlation between what they tell us and what we can measure,” Raveendran told Infectious Diseases in Children.
The 23 patients enrolled in the study ranged in age from 4 to 18 years, with 39% having a diagnosis of asthma and 35% of patients with allergic rhinitis; 65% of patients had non-allergic rhinitis. The most severe symptoms reported were congested/blocked nose [mean 3.9 (maximum 5)], waking up tired (mean 3.5), and need to blow nose (mean 3.2). Total symptom scores were not significantly different among patients with allergy compared with no allergy (P=1) or asthma compared with no asthma (P=.5).
“What we found so far is that with pediatric patients, the parents and the patients – although they chose different symptoms – resulted in the same overall symptom score. Therefore, the patient thought they had severe symptoms and the parent also recognized that they had severe symptoms,” she said.
Overall the mean absolute minimum cross-sectional area was 0.34 cm2.
An unexpected finding of the study, according to Raveendran, is that symptom scores did not correlate with ‘‘bother’’ scores (P=.1) or acoustic rhinometry results (P=.1).
“With the acoustic rhinometry as our objective measure, we didn’t find the correlation we thought we would between the questionnaire and the acoustic rhinometry,” Raveendran said, adding that additional studies are needed.
Disclosure: Dr. Raveendran reports no relevant financial disclosures.
For more information:
- Raveendran R. #430. Using Objective Tools to Evaluate Pediatric Patients with Chronic Rhinitis. Presented at: The AAAAI 2012 Annual Meeting; March 2-6, 2012; Orlando, Fla.