RHINITIS Miss H. Babar-Craig.

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Presentation transcript:

RHINITIS Miss H. Babar-Craig

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

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

Lateral Nasal Anatomy

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 SAMTER’S Triad Aspirin allergy, asthma, polyps

Allergic Rhinitis

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

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

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

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

Non-Allergic Rhinitis Clinical Features : 1. Older age, perennial 2. Nasal obstruction 3. Rhinorrhoea 4. Polyps, anosmia 5. Sinusitis more common

Non-Allergic Rhinitis Management: 1. Antibiotics 2. Nasal steroids 3. Nasal decongestion eg ephedrine, otrivine 4. Surgical – Septoplasty - Submucous diathermy - Turbinate Reduction - FESS