ALLERGIC RHINITIS
Authors: Spaskova Vaska 
Published: December 2021

The sinuses are bone cavities, coated with mucous membrane (mucosa), filled with air.The bone structure of the human skull is complex and interesting. The large number of paranasal sinuses greatly relieve the weight of the head and thus the load on the spine becomes significantly lower. There are 4 sets of so-called paranasal sinuses: two frontal sinuses, placed in the forehead, above the eyes, two maxillary (jaws), located in the upper jaw, an ethmoidal sinus, built of 18 to 22 small cavities, is located behind the nasal occipital sinus, located behind the nose and under the brain. Rhinosinusitis is divided into: acute, subacute and chronic. Sinusitis is graded according to the etiological factor: fungal, viral, allergic, bacterial, mixed, medicamentous, traumatic, aseptic, septic. The forms of the disease in relation to the nature of the inflammation are: exudative sinusitis, serous form, edematous cataract, purulent, productive, parietal-hyperplastic, cystic, polypous, alternative, hypostomal, necrotic, atrophic, mixed. Allergic rhinitis is an inflammatory response of the nasal mucous membrane to allergenic stimuli, mediated by IgE, characterized by one or more nasal or ocular clinical symptoms. Allergic disease is one of the most common non-communicable diseases and because of its high frequency it is called "21st Century Epidemic". Epidemiological studies suggest that about 25% of the world's population (ARIA) suffer from an allergy. It has been found that 10 to 25% of people have allergic sneezes, the most common manifestation of allergic diseases. The symptoms of rhinitis resemble a cold, but if the cold lasts more than a week and always occurs at the same time of the year, it is most likely allergic rhinitis. Most often sneezing, usually multiple times in a row, runny nose discharge, swelling of blood vessels, which patients feel as clogged nose, sometimes with loss of sense of smell. Allergic rhinitis reduces concentration, causes headaches, affects work ability and is a reason for absenteeism from school or work, and can significantly reduce quality of life. Up to 75% of adults with rhinitis think the disease affects their professional lives. It is often associated with other diseases of the upper respiratory tract, such as inflammation of the sinuses, ear, or nasal polyps. Diagnostic studies are as follows: Carefully taken history of disease, previous history of atopy, character of symptoms (seasonal or year-round, intermittent or persistent symptoms according to ARIA classification), symptoms (clear nasal secretion, nasal congestion, nose, rhinorrhea, sneezing), about 70% of patients with allergic rhinitis also have symptoms of conjunctivitis (redness, tearing, itching), associative diseases (sinusitis, otitis media, asthma), exposure data (especially if we suspect occupational disease), rhinosinusitis nasal mucosa (complete eARL examination indicated at first visit) if patient complains of nasal congestion. The goal is to detect nasal polyps, a pale grayish gray or blue mucous membrane (indicating an allergic reaction, but other types of signs do not rule out allergies). The secretion can vary from purely watery to mucous. An ultrasound examination may check for the presence of secretion in the maxillary sinuses if symptoms indicate acute sinusitis. X-rays of the paranasal sinuses exclude chronic sinusitis, especially if symptoms persist for a long time (months to years). Children should only have sinus X-rays after careful evaluation. Serum IgE and/or skin screening tests are indicated to plan treatment, to use allergen-specific immunotherapy (desensitization), and to diagnose occupational rhinitis.