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Rhinitis
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Vinay Mehta, Srinivasan Ramanuja, Pramod S Kelkar
Atrophic rhinitis is a syndrome of progressive atrophy of the nasal mucosa seen in older adults. Such individuals report chronic nasal congestion and smell a persistent bad odor. This condition is associated with mucosal colonization with Klebsiella ozaenae. A variant occurs in patients who have had multiple sinus surgeries resulting in loss of normal mucociliary function.
Non-Allergic Perennial Rhinitis
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Jameel Muzaffar, Shahzada K. Ahmed
Primary atrophic rhinitis is a condition that occurs predominantly in women and is characterized by progressive atrophy of the nasal mucosa and underlying bone of the turbinates.1,2 This leads to the formation of thick crusts, which leave a constant foul smell (ozaena) in the nose.1,2 Furthermore, the nasal cavities are enlarged and there is the sensation of nasal congestion. Although the precise aetiology of this condition is not clear, it has been suggested that this may be a result of infection with Klebsiella ozaenae and other bacteria. However, primary atrophic rhinitis is distinct from secondary atrophic rhinitis, which develops directly as a result of granulomatous nasal infections, chronic rhinosinusitis, excessive nasal surgery, trauma and irradiation.
The nose and nasopharynx
Published in Rogan J Corbridge, Essential ENT, 2011
Nowadays, in developed countries atrophic rhinitis is associated with an abnormal patency of the nostril, usually as a result of nasal surgery, particularly turbinate resection, and in patients who have undergone radiotherapy for cancers involving the nasal cavity. The nasal lining loses its cilia and atrophies. Thick secretions are formed, which quickly dry and lead to large crusts with a characteristic unpleasant sweet odour. Bleeding is frequent. Nasal toilet is required regularly, and the patient is encouraged to use steam inhalations and glucose-in-glycerin nose drops in an attempt to soften the crusts. The most effective treatment is surgically to close off the nostril. However, this is often poorly tolerated by the patient. With the cessation of airflow, the nasal lining returns to normal, but when the airway is reopened the problem returns.
Underwater posterior nasal neurectomy compared to resection of peripheral branches of posterior nerve in severe allergic rhinitis
Published in Acta Oto-Laryngologica, 2021
Seiichiro Makihara, Mitsuhiro Okano, Syotaro Miyamoto, Kensuke Uraguchi, Munechika Tsumura, Shin Kariya, Mizuo Ando
To prevent severe postoperative nasal bleeding, we did not injure the SPA around the sphenopalatine foramen. Resection of peripheral branches of the posterior nasal nerve in the inferior turbinate is less invasive, but the peripheral branches of the SPA and veins were also resected simultaneously. Humidification and warming of inspired air, mucociliary activity, and removal of particulate material are essential nasal functions that are greatly impaired in disorders such as atrophic rhinitis and empty nose syndrome. Lack of humidification and glandular destruction can lead to mucosal dryness and crusting after turbinate surgery [11]. Resection of the posterior nasal nerve trunk at the sphenopalatine foramen without resecting the SPA has a positive effect on humidification inside the nose. We think that peripheral branches of the posterior nasal nerve do not need to be resected together if the posterior nasal nerve trunk is resected. In this study, two patients in the Underwater group had minor anterior nasal bleeding from the incision of the anterior inferior turbinate when we removed the chitin-coated gauze one day after the surgery. We think the bleeding occurred because the gauze rubbed against the incision. Instead of using chitin-coated gauze, using calcium alginate might decrease the frequency of nasal bleeding. If patients continue irrigation after the surgery, the calcium alginate will be washed out gradually [12]. If there is still calcium alginate in the nasal cavity when the patients visit the hospital about two weeks after the surgery, it will be removed by suctioning.
Bilastine: a lifetime companion for the treatment of allergies
Published in Current Medical Research and Opinion, 2020
Martin K. Church, Marysia Tiongco-Recto, Erminia Ridolo, Zoltán Novák
The most common allergic diseases in elderly people include allergic rhinitis (approximately 5–11%) and chronic urticaria (prevalence in elderly uncertain but general prevalence around 0.5–1%)46. In elderly individuals, allergic rhinitis often occurs in association with other types of chronic non-allergic rhinitis (e.g. atrophic rhinitis, vasomotor rhinitis, drug-related rhinitis)66. Chronic urticaria in the elderly is often associated with the general consequences of skin aging, such as atrophy of the epidermis and dermis, progressive deterioration of skin structural integrity and function, impaired skin barrier function and immune response, vascular impairment, and a build-up of reactive oxygen species67. Urticaria in the elderly may be induced by systemic diseases or may be drug-induced68.
Diagnosis and treatment of non-allergic rhinitis: focus on immunologic mechanisms
Published in Expert Review of Clinical Immunology, 2021
Yifan Meng, Chengshuo Wang, Luo Zhang
According to a recently published position paper by the European Academy of Allergy and Clinical Immunology, NAR can be subclassified into six subgroups; including senile rhinitis, gustatory rhinitis, occupational rhinitis, hormonal rhinitis, drug-induced rhinitis, and idiopathic rhinitis (IR). Similarly, Papadopoulos et al [4]have classified NAR into several subgroups; including idiopathic rhinitis (also known as vasomotor rhinitis), gustatory rhinitis, drug-induced rhinitis, rhinitis of the elderly, atrophic rhinitis, local allergic rhinitis, and occupational rhinitis. However, owing to the complications associated with NAR subclassification and similarities in their treatment, the former phenotypes of NAR could not meet the needs of precision medicine; a new strategy for optimizing treatment efficacy by providing individualized management based on a diagnosis, treatment approaches, and prevention of disease progression [5]. Thus, further investigations to specifically characterize the endotypes of NAR according to the aforementioned classifications are warranted. Indeed, a more recent study has subclassified NAR into four endotypes; including nonallergic rhinitis with eosinophilia syndrome (NARES) with asthma, NARES without asthma, local allergic rhinitis (LAR) and IR, based on a cluster analysis of 12 clinical variables in both the upper airway and lower airways characteristics [6]. Furthermore, five inflammatory variables were measured to investigate the inflammatory patterns associated with the different clusters to provide a more comprehensive analysis of each endotype, which may help in delivering individualized treatment.