RHINOLOGY: RHINITIS AND SINUSITIS

Allergic Rhinitis

Hypersensitivity mediated by immunoglobulin E

Caused by tree pollen, house dust, animal fur, food allergens.

Asthma and atopic dermatitis frequently associated with allergic rhinitis.

Diagnosed by skin prick allergy test, which measures Ige IN Blood

Treatment- avoiding allergen and oral antihistamines (Loratadine) and intra-nasal steroids (Fluticasone).

Non-allergic Rhinitis

Not mediated by IgE

Caused by Irritants: tobacco, pollution, Infections, Temperature changes, Pharmacological: after prolonged use of topical decongestants.

Diagnosed by allergic investigations are needed to exclude allergic causes.

Treatment by intranasal steroids and surgery if needed, which consits of conchae reduction to alleviate nasal obstruction.

Acute Sinusitis

Most commonly viral but can also be bacterial infection.

Diagnosed by nasendoscopy to see if [pus discharge from sinus drainage to the nasal cavity.

Complications: Meningitis, Osteomyelitis, Orbital abscess and cellulitis

Diagnosed by blood test or CT scan if severe complications.

Treated by Nasal saline irrigation or intranasal steroids if mild, sever symptoms treat with broad-spectrum antibiotics.

Chronic sinusitis

Causes: Allergic, Inflammatory, Infectious,Secondary to medication, Secondary to drugs (cocaine)

Diagnosed by CT scan

Treatment: Intra-nasal steroid, antibiotic, sinus surgery in refractive cases.