Ragweed Allergic Rhinitis and the Paranasal Sinuses: A Computed Tomographic Study

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Abstract
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 μg 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. Arch Otolaryngol Head Neck Surg. 1997;123:193-196