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
Loesel LS. Allergy and Enlarged Adenoids. JAMA. 1988;260(12):1716–1717. doi:10.1001/jama.1988.03410120062022
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