Assessment of Rigid Nasopharyngoscopy Beyond the Nasal Cavity in Diagnosis of Immune-mediated Nasopharyngeal Allergic Diseases
Abstract
Rigid nasopharyngoscopy is a valuable diagnostic method for immune-mediated allergy conditions, particularly for children aged≤6 years. In addition to evaluating the structural characteristics of the nasal cavity, the procedure also reveals inflammatory activity in the nasopharyngeal framework.
This study assessed 110 pediatric patients between 2 and 6 years old who presented with suspected allergic conditions. Rigid nasopharyngoscopy was performed, and its diagnostic performance was high with 85.45% sensitivity, 78.18% specificity, and an overall diagnostic accuracy of 83.00%, which supports its role in diagnosing and ruling out allergic disorders.
The findings revealed strong associations between mucosal erythema, cobblestoning, and mucosal secretions with symptoms like nasal obstruction and postnasal drip. These signs have proven to be reliable indicators of inflammation and chronic irritation in this age group. The procedure was well tolerated, and over 85% of children experienced no adverse effects.
Minor discomfort and nasal bleeding were reported in a small number of cases. Taken together, the results show that rigid nasopharyngoscopy is an essential diagnostic modality for early detection of allergy conditions in the pediatric population.
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21. Matsumoto K, Okada H, Yoshino Y. Diagnostic accuracy of rigid nasopharyngoscopy in pediatric allergic diseases. Pediatr Allergy Immunol. 2020;31(3):292-8.
22. Muraro A, Lemanske RF, Castells M. Precision medicine in allergic diseases. J Allergy Clin Immunol. 2019;144(1):29-44.
23. Patel ZM, Hwang PH, Nayak JV. Advances in endoscopic techniques for allergic rhinitis management. J Otolaryngol Head Neck Surg. 2020;49(1):15-23.
24. Pawankar R. Immunopathology of allergic diseases: A 2020 perspective. Immunol Allergy Clin North Am. 2020;40(1):1-15.
25. Perez L, Morales D, Zhang K. Pre-procedure comfort strategies in nasopharyngoscopy. Ann Otol Rhinol Laryngol. 2020;55(2):85-92.
26. Phillips DM, Taylor HB, Jenkins JR. Molecular diagnostics in allergic rhinitis. Allergy Clin Immunol Int. 2022;34(3):125-35.
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28. Scadding GK, Kariyawasam HH, Mirakian R. Diagnosis and management of allergic and non-allergic rhinitis: A UK practice guide. Allergy. 2020;75(3):679-89.
29. Sharma V, Kaushal S, Gupta S. Endoscopic diagnosis in allergic rhinitis: A prospective study. Int Forum Allergy Rhinol. 2021;11(7):874-81.
30. Singh A, Mathur P, Yadav S. Correlation of anatomical findings with symptoms in chronic rhinosinusitis using rigid endoscopy. Am J Rhinol Allergy. 2021;35(2):181-88.
31. Stokes JR, Casale TB, Burks AW. Allergy and immunology: State of the art review. J Allergy Clin Immunol. 2022;149(4):1096-11.
32. Sun Y, Wang X, Zhao T. Post-treatment evaluation of allergic rhinitis using nasopharyngoscopy. J Rhinol. 2023;30(1):21-9.
33. Tan BK, Phillips CD, Schleimer RP. Advances in nasal endoscopy for allergic rhinitis diagnosis and treatment. Ann Allergy Asthma Immunol. 2020;125(6):630-9.
34. Vega R, Montesinos E, Aranda R. Combining imaging and endoscopy in allergic rhinitis diagnostics. Eur Arch Otorhinolaryngol. 2022;279(5):1203-12.
35. Wang J, Luo Y, Lin Z. Histopathological findings in allergic rhinitis patients using nasopharyngoscopy. Int J Otolaryngol. 2022;61(3):173-82.
36. Zhang L, Lou H, Wang Y. Allergic rhinitis and its impact on asthma: Role of endoscopic evaluation. Allergy. 2019;74(4):742-50.
37. Zhao Q, He M, Liu Z. Diagnostic value of rigid nasopharyngoscopy in allergic rhinitis: A meta-analysis. Clin Rev Allergy Immunol. 2021;61(3):368-76.
38. Zhou C, Gao R, Li X. Application of nasopharyngoscopy in evaluating therapeutic outcomes of allergic rhinitis treatment. Eur Arch Otorhinolaryngol. 2023;280(2):509-18.
2. Anderson, KL, Wilson J D, Spencer JA. Biomarkers in allergic rhinitis: A focus on nasal cytology. J Allergy Immunol. 2023;15(2);211-23.
3. Bousquet J, Schünemann HJ, Togias A, Erhola M, Hellings PW. Next-generation allergic rhinitis and its impact on asthma (ARIA) guidelines for allergic rhinitis management. Allergy. 2021;6(5):1509-26.
4. Chen Y, Zhang, Q, Liu Y. Rigid nasopharyngoscopy in pediatric allergic conditions: A focus on diagnostic outcomes. Ped Allergy Immunol. 2021;32(3):301-8.
5. Chowdhury R, Gupta S, Basu A. Advances in endoscopic imaging for allergic rhinitis: A systematic review. Journal of Otolaryngology and Head & Neck Surgery. 2021;50(2):98-110.
6. Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al. International ERS/ATS guidelines on definition, evaluation, and treatment of severe asthma. Europ Res J. 2014;57(2):1-20.
7. Creticos PS, Bernstein D I, Ledford D K. Advances in diagnosing allergic rhinitis: A clinical perspective. J Allergy Clin Immunol Practice. 2020;8(6):1765-72.
8. Fang H, Li Q, Zhang W. Dynamic visualization of mucosal changes during allergen exposure: Insights from nasopharyngoscopy. Clin Allergy Immunol. 2020;12(5):578-87.
9. Gautier C, Dastous S, Desjardins M. Global trends in allergic rhinitis: Epidemiological insights. Allergy Asthma Clin Immunol. 2021;17(1):1-10.
10. Gupta, A., Singh, M., & Agarwal, R. (2022). Diagnostic role of nasopharyngoscopy in chronic rhinosinusitis: A comprehensive review. Indian Journal of Otolaryngology and Head & Neck Surgery, 74(1), 128-134. https://doi.org/10.1007/s12070-021-02668-4.
11. Huang J, Wang C, Xie Q. The role of nasopharyngoscopy combined with CT in allergic rhinitis diagnostics. Rhinol J. 60(4):232-40.
12. Jiang Y, Sun W, Chen Z. Artificial intelligence-enhanced nasopharyngoscopy: A step towards precision diagnostics. Front Allergy. 2022;3:1-12.
13. Khan MS, Rashid R, Ahmed F. Structural abnormalities in allergic rhinitis: Endoscopic insights. J Allergy Clin Immunol Practice. 11(3):525-33.
14. Kim JH, Cho SH, Kim KR, Park JH. Advances in nasal endoscopy for allergic rhinitis: Diagnostic and therapeutic perspectives. Clin Exp Allergy. 2023;53(1):22-31.
15. Kumar R, Singh V, Tandon N. Rigid nasopharyngoscopy in the evaluation of allergic rhinitis: Clinical implications. Am J Rhinol Allergy. 2022;34(6):676-82.
16. Lee SH, Park HJ, Kim SH. Nasal endoscopy: A cornerstone in the diagnosis of allergic diseases. Allergy Asthma Immunol Res. 2021;13(5):629-637.
17. Liang C, Zhao H, Lin Y. High-definition optics in nasopharyngoscopy: Advances in chronic inflammation diagnostics. J Clin Otolaryngol Head Neck Surg. 2021;48(3):342-51.
18. Lin P, Zhou M, Zhang J. Pediatric applications of rigid nasopharyngoscopy: Implications for allergy management. Int J Pediatr Otorhinolaryngol. 2021;39(4):112-21.
19. Liu J. Integration of biomarkers and endoscopic findings in allergic rhinitis. Front Allergy. 2022;3:1-10.
20. Luo J, Shen W, Yu Z. Fractional exhaled nitric oxide and rigid endoscopy: A combined approach in allergic rhinitis diagnosis. J Asthma Allergy. 2021;14:879-90
21. Matsumoto K, Okada H, Yoshino Y. Diagnostic accuracy of rigid nasopharyngoscopy in pediatric allergic diseases. Pediatr Allergy Immunol. 2020;31(3):292-8.
22. Muraro A, Lemanske RF, Castells M. Precision medicine in allergic diseases. J Allergy Clin Immunol. 2019;144(1):29-44.
23. Patel ZM, Hwang PH, Nayak JV. Advances in endoscopic techniques for allergic rhinitis management. J Otolaryngol Head Neck Surg. 2020;49(1):15-23.
24. Pawankar R. Immunopathology of allergic diseases: A 2020 perspective. Immunol Allergy Clin North Am. 2020;40(1):1-15.
25. Perez L, Morales D, Zhang K. Pre-procedure comfort strategies in nasopharyngoscopy. Ann Otol Rhinol Laryngol. 2020;55(2):85-92.
26. Phillips DM, Taylor HB, Jenkins JR. Molecular diagnostics in allergic rhinitis. Allergy Clin Immunol Int. 2022;34(3):125-35.
27. Ponikau JU, Frigas E. Epithelial barrier dysfunction in allergic diseases: Pathophysiological implications. Curr Allergy Asthma Rep. 2021;21(2):73-84.
28. Scadding GK, Kariyawasam HH, Mirakian R. Diagnosis and management of allergic and non-allergic rhinitis: A UK practice guide. Allergy. 2020;75(3):679-89.
29. Sharma V, Kaushal S, Gupta S. Endoscopic diagnosis in allergic rhinitis: A prospective study. Int Forum Allergy Rhinol. 2021;11(7):874-81.
30. Singh A, Mathur P, Yadav S. Correlation of anatomical findings with symptoms in chronic rhinosinusitis using rigid endoscopy. Am J Rhinol Allergy. 2021;35(2):181-88.
31. Stokes JR, Casale TB, Burks AW. Allergy and immunology: State of the art review. J Allergy Clin Immunol. 2022;149(4):1096-11.
32. Sun Y, Wang X, Zhao T. Post-treatment evaluation of allergic rhinitis using nasopharyngoscopy. J Rhinol. 2023;30(1):21-9.
33. Tan BK, Phillips CD, Schleimer RP. Advances in nasal endoscopy for allergic rhinitis diagnosis and treatment. Ann Allergy Asthma Immunol. 2020;125(6):630-9.
34. Vega R, Montesinos E, Aranda R. Combining imaging and endoscopy in allergic rhinitis diagnostics. Eur Arch Otorhinolaryngol. 2022;279(5):1203-12.
35. Wang J, Luo Y, Lin Z. Histopathological findings in allergic rhinitis patients using nasopharyngoscopy. Int J Otolaryngol. 2022;61(3):173-82.
36. Zhang L, Lou H, Wang Y. Allergic rhinitis and its impact on asthma: Role of endoscopic evaluation. Allergy. 2019;74(4):742-50.
37. Zhao Q, He M, Liu Z. Diagnostic value of rigid nasopharyngoscopy in allergic rhinitis: A meta-analysis. Clin Rev Allergy Immunol. 2021;61(3):368-76.
38. Zhou C, Gao R, Li X. Application of nasopharyngoscopy in evaluating therapeutic outcomes of allergic rhinitis treatment. Eur Arch Otorhinolaryngol. 2023;280(2):509-18.
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| Issue | Articles in Press | |
| Section | Original Article(s) | |
| Keywords | ||
| Allergic Allergic rhinitis Autoimmune diseases Endoscopy Nasopharyngoscopy rhinitis Perennial Rhinitis allergic seasonal | ||
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How to Cite
1.
Wang H, Zhu P, Geng J, Yu P, Dong J. Assessment of Rigid Nasopharyngoscopy Beyond the Nasal Cavity in Diagnosis of Immune-mediated Nasopharyngeal Allergic Diseases. Iran J Allergy Asthma Immunol. 2025;:1-10.
