Control of nasal obstruction in perennial allergic rhinitis.
OBJECTIVE
Nasal obstruction, the cardinal symptom of persistent (perennial) allergic rhinitis, is one of the most common symptoms encountered in primary care and in specialist clinics. It is difficult to quantify by clinical examination, and, hence, objective assessment of the nasal airway is critical to rhinologic research. Nasal obstruction in persistent allergic rhinitis must be treated the year round, and therefore treatment choices, costs, and compliance all become important public health issues.


RESULTS
Many inflammatory and neurogenic mediators released during allergic reactions are able to cause plasma exudation and vasodilatation, with resultant edema and swelling of the nasal mucosa. Recently, technological advancements have made it possible to qualitatively and quantitatively study the nasal airway, providing greater insights into the understanding of physiological fluctuation and pathophysiological manifestations of nasal patency. From recent international guidelines, the management of allergic rhinitis includes combining treatments of the upper and lower airways, by using patient education, allergen avoidance, pharmacological treatment, and specific immunotherapy. Surgery may be needed as an adjunctive intervention. Multiple methods have been introduced to treat turbinate hypertrophy. However, preservation of adequate nasal mucosal function is important, together with long-term results.


CONCLUSIONS
It is important that consensus recommendations for the management of allergic rhinitis be designed and implemented by all levels of medical specialists in order to improve treatment outcomes.
Wang
De-Yun
DY
Department of Otolaryngology, Faculty of Medicine, National University of Singapore. entwdy@nus.edu.sg
Raza
Md Tanveer
MT
Gordon
Bruce R
BR
D002867:Chromones / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D014663:Nasal Decongestants / Q000627:therapeutic use; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D012221:Rhinitis, Allergic, Perennial / Q000150:complications / Q000517:prevention & control / Q000628:therapy*; D013177:Sports
D002867:Chromones; D005938:Glucocorticoids; D006634:Histamine H1 Antagonists; D020024:Leukotriene Antagonists; D014663:Nasal Decongestants