Efficacy of Sublingual Immunotherapy in Allergic Rhinitis Patients with Asthma: A Systematic Review and Meta-Analysis.

OBJECTIVE: Sublingual immunotherapy (SLIT) has been widely applied to treat patients with allergic rhinitis (AR). However, meta-analyses on the efficacy of SLIT in AR patients with asthma are still limited. METHODS: Literature without language limitation published before October 28, 2022, were retrieved from PubMed, EMBASE, and Cochrane Library. STATA 16.0 software was used for the meta-analysis of the extracted data. The results reported were symptom scores, drug scores, adverse effects rates, and cost of treatment. RESULTS: Ten studies involving 1722 patients met the inclusion criteria. The total rhinitis score (TRSS) (weighted mean difference [WMD] = -1.23, 95% CI: -1.39--1.06, P < .001) and total asthma symptom score (TASS) (WMD = -1.00, 95% CI: -1.12-0.89, P < .001) were significantly lower in the SLIT group than the placebo group. The SLIT group had higher rates of treatment-related adverse events (relative risk [RR] = 2.82, 95% CI: 1.77-4.48, P < .001) and total costs of treatment (standardized mean difference [SMD] = 0.71, 95% CI: 0.45-0.97, P < .001). There was no significant difference in inhaled corticosteroids (ICS) dose (P = .195), fractional exhaled nitric oxide (FeNO) (P = .158), forced expiratory volume in 1 s (FEV1) (P = .237), and direct costs of treatment (P = .630) between the SLIT and placebo groups. CONCLUSION: SLIT may be a therapeutic method for improving rhinitis symptoms and asthma symptoms in AR patients with asthma. However, as there was significant heterogeneity in results, more high-quality and well-designed studies are needed in the future to elucidate the efficacy of SLIT.

Modified sphenoidotomy for isolated sphenoid sinus disease: A series of 117 cases.

BACKGROUND: The atresia rate of sphenoid ostium after endoscopic sphenoidotomy for isolated sphenoid disease is 9.4%-10.2%. AIMS: To reduce sphenoid sinus ostium atresia rate after sphenoidotomy surgery. MATERIALS AND METHODS: The data of patients with isolated sphenoid sinus disease at our hospital between 2015 and 2022 were retrospectively analyzed. The age, gender, disease course, pathology, postoperative follow-up time, anatomy data of sphenoid sinus and postoperative sinus ostium atresia rate were compared between the two groups of patients with traditional sphenoidotomy and modified sphenoidotomy. RESULTS: A total of 117 patients with isolated sphenoid sinus disease underwent endoscopic sphenoidotomy. There were 76 cases in the traditional sphenoidotomy group, fungus ball in 59.2% of patients, the postoperative sinus ostium atresia rate was 14.5%. There were 41 cases in the modified sphenoidotomy group, fungus ball in 53.6% of patients, and 0 case of sinus ostium atresia. Statistical analysis showed significant differences in postoperative sinus ostium atresia rate. There was no significant difference in age, pathology, postoperative follow-up time, anatomy data of sphenoid, and other data. CONCLUSIONS AND SIGNIFICANCE: The modified endoscopic sphenoidotomy may reduce the rate of postoperative sinus ostium atresia.

Clinical study on the treatment of moderate to severe persistent allergic rhinitis by posterior nasal nerve combined with anterior ethmoid neurotomy.

Objectives: To investigate the clinical effect of posterior nasal nerve combined with anterior ethmoid neurotomy in the treatment of moderate to severe persistent allergic rhinitis. Methods: Thirty patients with moderate to severe persistent allergic rhinitis admitted to Linhai Second People's Hospital from August 2019 to June 2020 were selected as subjects for prospective study and design. All patients underwent posterior nasal neurotomy and anterior ethmoid neurotomy simultaneously. Subsequently, the efficacy of all patients at 0.5 and one year postoperatively was compared. Their symptom score preoperatively and one year postoperatively as well as their preoperative and postoperative quality of life score were compared, and related adverse reactions were collected. Results: The curative effect ratio was 60% after 0.5 years and 90.0% after one year, showing a significant increase (χ2 =12.000, P=0.007<0.05). The symptom score at one year postoperatively (1.15±0.32) was lower than that preoperatively (2.12±0.58), with a statistically significant difference (t=11.351, P=0.000<0.05); In terms of quality of life, nasal symptoms, ocular symptoms, practical difficulties, sleep disorders, emotional disorders and other symptoms were lower than those preoperatively, with statistically significant differences (P<0.05). Adverse reactions occurred in 4 patients (13.33%), but were eliminated after treatment. Conclusion: Posterior nasal nerve combined with anterior ethmoid neurotomy is a safe and reliable surgical method for the treatment of moderate to severe persistent allergic rhinitis, boasting a variety of benefits such as symptomatic relief, improved quality of life, and reduced adverse reactions, which is worthy of clinical promotion.

Effect of azelastine hydrochloride combined with montelukast sodium in the treatment of patients with allergic rhinitis.

OBJECTIVE: To investigate efficacy of azelastine hydrochloride combined with montelukast sodium in the treatment of patients with allergic rhinitis. METHODS: A total of 137 patients with allergic rhinitis in our hospital were divided into two groups, 70 patients in the experimental group received azelastine hydrochloride combined with montelukast sodium treatment, while 67 patients in the control group were given only azelastine hydrochloride treatment. The clinical therapeutic effect, clinical symptom score and serum levels of inflammatory factors were recorded. RESULTS: The clinical therapeutic effect of the two groups after treatment were improved compared to those without intervention (P < 0.05), and the total effective rate of the experimental group was 94.3% (66/70), which was higher than that of the control group (83.6%). The clinical symptom score (nasal itching, nasal congestion and runny nose) of two groups was decreased after receiving the intervention, and the scores in the experimental group were much lower than the control group after receiving the intervention (P < 0.05). The serum levels of inflammatory factors (IL-6, IL-8 and hsCRP) were obviously lower in the two groups after treatment, and those levels in the experimental group were much lower than the control group after receiving the intervention. Furthermore, after the receiving treatment, the levels of each of the inflammatory and anti-inflammatory factors in the experimental group were significantly ameliorated compared to those in the control group (P < 0.05). CONCLUSION: Azelastine hydrochloride combined with montelukast sodium can effectively improve clinical symptoms and inflammatory reactions in patients with allergic rhinitis; furthermore, this research provides ideas for clinical practice.