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Inflammation of the nasal mucous membrane is called rhinitis.
The symptoms include sneezing, runny nose, and itching, caused
by irritation and congestion in the nose. There are two types:
allergic rhinitis and non-allergic rhinitis.
This condition occurs when the body's immune
system over-responds to specific, non-infectious particles such
as plant pollens, molds, dust mites, animal hair, industrial
chemicals (including tobacco smoke), foods, medicines, and insect
venom. Essentially, during an allergic attack, antibodies, primarily
immunoglobin E (IgE), attach to mast cells in the lungs, skin,
and mucous membranes. Once IgE connects with the mast cells,
a number of chemicals are released. One of the chemicals, histamine,
opens the blood vessels and causes skin redness and swollen membranes.
When this occurs in the nose, sneezing and congestion are the
result.
or hayfever occurs in late summer
or spring. Hypersensitivity to ragweed, not hay, is the primary
cause of seasonal allergic rhinitis in 75 percent of all Americans
who suffer from this seasonal disorder. People with sensitivity
to tree pollen have symptoms in late March or early April; an
allergic reaction to mold spores occurs in October and November
as a consequence of falling leaves.
occurs year-round and can result
from sensitivity to pet hair, mold on wall paper, house plants,
carpeting, and upholstery. Some studies suggest that air pollution
such as automobile engine emissions can aggravate allergic rhinitis.
Although bacteria is not the cause of allergic rhinitis, one
medical study found a significant number of the bacteria Staphylococcus
aureus in the nasal passages of patients with year-round allergic
rhinitis, concluding that the allergic condition may lead to
higher bacterial levels, thereby creating a condition that worsens
the allergies.
This form of rhinitis does not depend
on the presence of IgE and is not due to an allergic reaction.
The symptoms can be triggered by cigarette smoke and other pollutants
as well as strong odors, alcoholic beverages, and the cold. Other
causes may include blockages in the nose, a deviated septum,
infections (in children), and over-use of medications such as
decongestants.
Recent studies by otolaryngologist-head and neck surgeons have
sought to better define the association between rhinitis and
sinusitis. They have concluded that sinusitis is often preceded
by rhinitis and rarely occurs without concurrent rhinitis. The
symptoms, nasal obstruction/discharge and loss of smell occur
in both disorders. Most importantly, computed tomography (CT
scan) findings have established that the mucosal linings of the
nose and sinuses are simultaneously involved in the common cold
(previously, thought to affect only the nasal passages). Otolaryngologists,
acknowledging the inter-relationship between the nasal and sinus
passages, now refer to sinusitis as rhinosinusitis.
The catalyst relating the two disorders is thought to involve
nasal sinus overflow obstruction, followed by bacterial colonization
and infection. The resulting nasal obstruction leads to acute,
recurrent, or chronic sinusitis; conversely, chronic inflammation
due to allergies can lead to obstruction and subsequent sinusitis.
Other medical research has supported the close relationship
between allergic rhinitis and sinusitis. In a retrospective study
on sinus abnormalities in 1,120 patients (from 2 to 87 years
of age), thickening of the sinus mucosa was more commonly found
in sinusitis patients during July, August, September, and December,
in which pollen, mold, or viral epidemics are prominent. A review
of patients (four to 83 years of age) who had surgery to treat
their chronic sinus conditions revealed that those with seasonal
allergy and nasal polyps are more likely to experience a recurrence
of their sinusitis.
Patients who suffer from recurring bouts of allergic rhinitis
should observe their symptoms on a continuous basis. If facial
pain or a green-yellowish nasal discharge occur, a qualified
ear, nose, and throat specialist can provide appropriate sinusitis
treatment.
© 2004 AAO-HNS/AAO-HNSF
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