People in Hong Kong are familiar with the word “allergic rhinitis”. Due to the poor air quality in Hong Kong, we always come across with people who are sneezing, having nasal congestion and runny noses. However, these symptoms also appear in other nasal disorders, such as sinusitis, nasal polyps and nasopharyngeal cancer (NPC). Therefore ENT doctors have to perform clinical examination to give an accurate diagnosis.
Examination for allergic rhinitis
Nasal congestion, runny nose, nasal bleeding, and poor olfactory sensory are common nasal symptoms. ENT doctors would first inquire about patient’s medical history, so as to understand their initial symptoms and their severity, as well as inquiring family history of NPC or other nasal disorders.
Besides past medical history and essential ENT examination, flexible nasoendoscopy may be performed when necessary. Through the flexible optic fiber can deeply penetrated into different position of the nasopharyngeal area, in order to examine any signs of pathological changes. Under normal circumstances, patients may perform such examination in the clinic. If biopsy is required for further investigation, performing the procedure in hospitals would be a safer choice.
Diagnosis of Allergic Rhinitis
Allergens are the culprit of allergic rhinitis, causing mild inflammatory response in the nasal cavity. To cure allergic rhinitis, the allergen must be identified. Currently there are two methods for diagnosis of allergic rhinitis. One is skin prick test. By injecting the allergen under the skin, if positive, the skin will appear to be red and swollen. Another method is blood test. By interpreting IgE elevation level of each allergen, the allergen can then be determined.
Treatment of allergic rhinitis
- Avoid allergens: Besides frequent cleaning to minimize exposure to dust, patients should use beddings with anti-dust mite properties, as well as avoiding close contacts with pets and smoking areas.
- Medications for allergic rhinitis: Use of anti-histamines, steroid sprays have minimal side effects. FDA has already approved the use of steroid sprays for children above 2 years old.
- Immunotherapy: the therapy usually takes about 3-5 years duration of treatment. If medication therapy fails or patients have asthma and skin allergy, they are indicated for this therapy.
- Surgical intervention: if patients have sinusitis or nasal polyps simultaneously, medication alone does not showed significant improvement, surgery may be a possible solution. For allergic rhinitis caused by deviated septum, septorhinoplasty or nasal turbinate resection can be performed to relieve nasal congestion and allergic rhinitis.
Allergic rhinitis surgery
Instead of traditional operations, there are also minimally invasive surgeries available nowadays, such as radiofrequency ablation. This is less traumatic than conventional surgeries. With the use of radiofrequency, the heat emitted would cause contraction of the nasal mucosa, relieving nasal congestion. Another method is to remove the excess soft tissues under the nasal mucosa or removing the extra cartilage.
This surgery is performed under general anesthesia which requires about 1-2 hours. Patients have to stay in hospital for 1-2 days after surgery. The effect can be seen 4-6weeks later, only small cases of recurrence. Surgical risks include wound infection and bleeding. Punctured nasal septum is extremely rare.
The information on this website is for general educational purpose only.
Readers should consult their physician before considering treatment, and should not interpret their condition solely based on the information above.