Polypoid changes of the middle turbinate as an indicator of atopic disease.

Background: High levels of local immunoglobulin E (IgE) have been demonstrated in nasal polypoid tissue; however, an association between nasal polyps and allergy has not been proven. The authors have observed that polypoid edema isolated to the leading edge of the middle turbinate (MT) is highly associated with allergic rhinitis. The objective of this study was to determine if there is an association between isolated MT polyps and inhalant allergy.

Methods: A single institution prospective study was performed. Twenty-five consecutive patients found to have isolated MT polyps on endoscopic exam were recruited. Nasal and allergy symptoms were documented on the intake form. Allergy testing was recommended to all patients.

Results: Of the 25 patients found to have isolated MT polypoid edema documented on endoscopic exam, 16 patients underwent skin or in vitro allergy testing. All of the patients tested positive for inhalant allergy.

Conclusion: This small series provides strong evidence to support an association between isolated MT polypoid edema and allergy. We recommend allergy testing in all patients with isolated MT polyps or polypoid edema.