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Ragweed allergic rhinitis and the paranasal sinuses. A computed tomographic study.

OBJECTIVE
To explore the potential association of allergic rhinitis and sinusitis.


DESIGN
Prospective clinical trial.


SETTING
Academic tertiary referral center.


PARTICIPANTS
Ten subjects with symptomatic ragweed allergy during the peak of the ragweed season.


MAIN OUTCOME MEASURES
We obtained a paranasal sinus computed tomographic scan on all volunteers and had them complete a modified Rhinitis Quality of Life Questionnaire. All subjects were then treated with intranasal aqueous beclomethasone dipropionate (168 micrograms twice a day) and completed the Rhinitis Quality of Life Questionnaire weekly until the end of the study.


RESULTS
Six of 10 of the subjects had sinus mucosal thickening on computed tomographic scan. All subjects improved symptomatically. A second computed tomographic scan was obtained after the pollen season in 5 patients with mucosal abnormalities, while the patients continued treatment with intranasal steroids and symptomatically improved. The sinus mucosal abnormalities persisted in all patients.


CONCLUSION
Despite the 60% incidence of abnormalities on the computed tomographic scans of the subjects with ragweed allergy during the season, these abnormalities appear, at most, to contribute minimally to the patient's symptoms, since resolution of symptoms was not accompanied by a reduction in sinus mucosal abnormalities.