Above picture shows patient undergoing nasal endoscopy for nasal problem

Relationship of Allergic Rhinitis(AR) with Rhinosinusitis/Asthma/Ear discharge/Dentofacial abnormalities &

Sleep disorder

What Is Allergic Rhinitis?

It is a reaction of your nose & sinuses to external & internal environment. The problem is more during the wet season
Patients usually presents with sneezing, rhinorrhea, nasal obstruction, headache, itching in nose, throat, ear.The patient
may have non-nasal symptoms like itchy eyes, headache, fatigue, skin allergy. To prevent complications like
rhinosinusitis, asthma, ear discharge, dentofacial abnormalities & sleep disorders, the patient should get examined by
ENT surgeon and investigated by nasal endoscopy etc.Treatment consist of nasal spray & antiallergic tablets.

Relationship of AR with Rhinosinusitis(RS)

About 25 to 70% of patients of AR have RS along with Asthma.They present with nasal blockage & discharge, sinus
headache, bad breath, breathing difficulty, tightness in chest. Diagnosis is on basis of clinical examination along with
collateral investigations like nasal endoscopy, spirometry & CT Scan.
It is managed by antibiotics, antiallergic decongestant tablets along with nasal spray. Surgery if there is nasal polyps,
sinus abscess, ophthalmic complications.

Relationship of RS with Asthma

About 40% patient of AR have asthma, vice versa 80% of asthmatics do have AR. The key symptoms of asthma are
cough, noisy breathing, breathlessness, chest tightness & excessive sputum production.Diagnosis is on the basis of
clinical findings, nasal endoscopy & spirometry. Treatment consist of anti-asthmatic drugs along with supportive therapy
and control of GERD, environmental stimulants.
Relationship of AR with Ear Discharge
About 50 to 70 % of kids have blockage of Eustachian tube which connects nose with ear, leading to pus discharge,
decrease hearing, blocked ear etc. It is managed by antibiotics, antihistamines along with decongestant & steam
inhalation.

Relationship of AR with Dentofacial abnormalities & Sleep disorder

Nearly 50 to 75 % of children’s with uncontrolled AR can have crooked teeth, mouth breathing, snoring etc.
Diagnosis is on basis of clinical findings, sleep study. Treatment consist of long-term management with antiallergic &
decongestant medicines.

Checklist for Allergic Rhinitis & Asthma Patients while traveling:

If going to USA check for the Pollen forecast, plan to go to mountains & beaches, carry necessary medications, avoid
carpeted rooms, travel in air-conditioned car during early morning, late evening & check for the availability of the medical
care.

Dr. Samit S. Bali MBBS, MS (ENT)

E:samitbali@in.com
Follow me on twitter@balinagpur
W:www.baliclinic.net