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
SAMTER’S 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