Chronic respiratory rhinitis: Toward endoscopic diagnosis of nasal allergy? An observational study

Objective: The study objective was to assess the functional, endoscopic and tomodensitometric semiology of a cohort of patients with chronic respiratory rhinitis (CRR). The concept of CRR is based on the anatom-ical, pathophysiological and semiological individualization of the respiratory nose within the sinonasal organ, in which three noses are distinguished by the parallel study of evolution and development in the evo-devo theory of the origins of the nose, anterior base of the skull and middle third of the face. Material and method: A single-center retrospective study included a cohort of 28 patients (16 men and 12 women, aged 19 to 69 years) with CRR. The main objective was to describe symptoms clinically, endoscopically and on CT. The secondary objective was to compare clinical symptomatology and CT data between CRR and a control group of 31 patients with nasal polyposis (NP). The endoscopic semiology of CRR was analyzed consensually on video recordings using a pre-established grid. The DyNaChron self-administered questionnaire was used to compare symptom intensity and deterioration in quality of life. Olfaction was compared using the Sniffin' Sticks test. CT opacities were compared between CRR and NP on Lund-Mackay sinus score and a specific ethmoid opacities score. Results: In CRR, endoscopy found a constant association of inflammatory or edematous signs in the inferior or middle turbinates with signs of hypersecretion. Ethmoid opacities in CRR were discrete and signifi-cantly smaller than in NP (P < 0.0001), and were mainly located in the medial compartment in contact with the olfactory cleft (P < 0.0001). Allergological assessment was positive in 17 of the 28 cases of CRR. Chronic nasal dysfunction was similar in CRR and NP, but olfactory impairment was significantly lower in CRR (P < 0.0001). Conclusion: The CRR entity clinically resembles atopic central compartment disease. In both entities, endoscopy reveals inflammatory lesions restricted to the nasal cavities without significant ethmoid opacity on CT, an observation which seems to contradict the pathophysiological united airway concept (c) 2022 Elsevier Masson SAS. All rights reserved.

Automated summary

The study assessed the functional, endoscopic, and tomodensitometric features of patients with chronic respiratory rhinitis (CRR). The findings revealed that CRR patients often have signs of inflammation or edema in the inferior or middle turbinates, along with hypersecretion. The ethmoid opacities in CRR were less significant and mainly located in the medial compartment near the olfactory cleft. Positive allergological assessments were observed in CRR cases, while olfactory impairment was significantly lower compared to a control group with nasal polyposis (NP).