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September 23, 1988

Allergy and Enlarged Adenoids

JAMA. 1988;260(12):1716-1717. doi:10.1001/jama.1988.03410120062022

To the Editor.—  The answers by Drs Voss and Healy to the inquiry by Dr Maloney regarding obstructed breathing and dental malocclusion1 prompts a response. During the past nine years we have examined 1673 adenoid tissues by an immunofluorescence method. The principal finding of this technique has been the demonstration of fluorescent mast-cell membrame-bound IgE (FIEMC) in conventional formalinfixed trypsinized tissue sections. The sensitivity and specificity in detection of upper airway allergy cases are 58% and 89%, respectively.2 Overall incidence of FIEMC positivity is 16%. Of 1382 cases for which we have follow-up in FIEMC-positive cases, 19 boys and 18 girls were referred by orthodontists, pediatricians, or family physicians because of malocclusive problems. An additional 15 children had mouth breathing as a significant entry in their histories. Although we do not have complete historical information for those children who are FIEMC negative, we believe that the incidence of