Correlation between skin prick test and MAST-immunoblot results in patients with chronic rhinitis.

BACKGROUND AND OBJECTIVES: The most reliable method for confirming the causative allergens of allergic rhinitis is the skin prick test, followed by the multiple allergen simultaneous test (MAST), which reportedly has acceptable sensitivity and specificity. This study was designed to confirm whether a novel MAST-immunoblot assay can reliably diagnose allergic rhinitis. METHODS: A retrospective chart review was conducted of chronic rhinitis patients who visited Yeouido St. Mary's Hospital between January 2010 and June 2011. RESULTS: In total, 193 subjects (111 male, 82 female) were included, with a mean age of 30.08 years (range 6-77). The skin prick test detected 132 subjects as having one or more positive responses to allergens, and MAST detected 105 subjects as having one or more positive response. The sensitivity, specificity, and efficiency of the MAST assay were 63.16%, 65.57%, and 63.92%, respectively. Sensitivity, specificity and efficacy for common allergens were not high enough for MAST to replace skin prick test in detecting causative allergens. When correlation was defined as a difference between the classes of MAST and SPT of less than 2, the correlation rates for Dermatophagoides farina and Dermatophagoides pteronyssinus were 65.80% and 59.07%, respectively. CONCLUSION: The correlation between MAST and the skin prick test is not sufficiently strong to use MAST as a diagnostic test to confirm the causative allergen in allergic rhinitis. Further studies to confirm the reliability of MAST should be conducted.

Risk factors for decreased distance between internal carotid artery and pharyngeal wall.

OBJECTIVES: The risk of disastrous bleeding during pharyngeal surgery is increased in cases of an internal carotid artery (ICA) that is medially displaced due to its anomalous course. We attempted to assess the distance between the ICA and the pharyngeal wall (DIP) and to evaluate the predisposing factors associated with ICA variation. METHODS: The course of ICA was studied in 509 CT scans, and a retrospective chart review was performed. The course of ICA and DIP were evaluated at each level of the pharynx: nasopharynx (NP), oropharynx (OP), and hypopharynx (HP). RESULTS: The mean DIP value was greatest (15.8±4.6mm) at NP, decreased at OP (15.8±4.6mm), and was shortest at HP (13.5±6.0mm). DIP was significantly shorter in females compared with males at all three pharyngeal levels. Age was inversely correlated with DIP at NP and OP. Tortuous ICA was most common (51.4%), followed by straight (41.2%), kinking (6.9%), and coiling (0.5%) types. DIP was longest in the straight type and decreased as the curvature of ICA increased. The most common ICA type differed between younger (<60 years; 56.2% having the straight type) and older groups (≥60 years; 66.2% having the tortuous type). Females older than 60 years displayed a higher incidence of kinking ICA compared with males. CONCLUSIONS: Hypopharynx, old age, female gender, and tortuous or kinking ICA types were risk factors for a decreased distance between the ICA and the pharyngeal wall. Meticulous examination of the pharyngeal wall should therefore be performed prior to pharyngeal surgery in patients with these associated risk factors.