RHINITIS

1
RHINITIS

• Miss H. Babar-Craig

2
Rhinitis

• Two main types
• 1. ALLERGIC RHINITIS
• 2. NON-ALLERGIC RHINITIS
• A. Eosinophilic
• B. Non-eosiniphilic

3
Allergic Rhinitis

• AETIOLOGY
• Type 1 Ig E Hypersensitivity reaction in the
  mucous membranes of the nasal airways
• Can be seasonal or perennial
• ALLERGENS
• Pollens, moulds , house dust mite, animal
  epithelia

4
Lateral Nasal Anatomy
5
Allergic Rhinitis

• CLINICAL FEATURES
• 1. Rhinorrhoea, anterior or PND
• 2. Nasal irritation, itching, vestibulitis
• 3. Sneezing, ichy watery eyes
• 4. Allergic Salute Sign
• 5. Long term nasal obstruction, anosmia, polyps
• SAMTERS Triad Aspirin allergy, asthma, polyps

6
Allergic Rhinitis
7
Allergic Rhinitis

• Investigations
• 1. Allergy tests, skin prick, blood RAST tests
• 2. CT sinuses only if sinusitis or polyps.

8
Allergic Rhinitis

• Management
• 1. Avoidance, dust/allergy advice sheet
• 2. Antihistamines
• 3. Topical Steroid Sprays nasonex, flixonase
• 4. Oral steroids
• 5. Surgical Submucous diathermy
• Turbinate reduction

9
Non-Allergic Rhinitis

• Two types
• 1. Eosinophilic
• 2. Non-eosinophilic
• Also known as intrinsic of non-infective
• Nasal secretions may or may not contain numbers
  of eosinophils

10
Non-Allergic Rhinitis

• Predisposing Factors
• 1. Family history
• 2. Preceding infection, leading to mucosal
  hypersensitivity.
• 3. Psychological, emotional factors
• 4. Endocrine, pregnancy, menstruation
• 5. Pollution, fumes, industrial agents, smoke
• 6. Smoking, alcohol

11
Non-Allergic Rhinitis

• Clinical Features
• 1. Older age, perennial
• 2. Nasal obstruction
• 3. Rhinorrhoea
• 4. Polyps, anosmia
• 5. Sinusitis more common

12
Non-Allergic Rhinitis

• Management
• 1. Antibiotics
• 2. Nasal steroids
• 3. Nasal decongestion eg ephedrine, otrivine
• 4. Surgical Septoplasty
• - Submucous diathermy
• - Turbinate Reduction
• - FESS