Allergic rhinitis is the most common chronic disease in our environment. It is estimated that it may affect 500 million people worldwide. If the history of allergic disease exists in both parents, the possibility of developing the disease occurs in more than 40%.
How is allergic rhinitis diagnosed?
It should be suspected when a patient presents: nasal itching, frequent sneezing, nasal obstruction or congestion, loss of smell and nasal mucous secretion that is produced or exacerbated by exposure to various triggers called allergens, generally environmental.
The complementary tests of choice are skin tests (prick tests), which can be used in patients of any age in whom sensitization is suspected.
What is the treatment?
Allergen avoidance measures should be an integral part of the management strategy. When initiating pharmacological treatment, the severity and duration of symptoms, patient preferences, as well as the efficacy, availability and cost of the medication should be considered.
Intranasal corticosteroids are the first-line drugs. It is preferable to use the latest generation, as they have been shown to have no systemic adverse effects.
On the other hand, antihistamines are effective against the symptoms of sneezing, mucous secretion, nasal and ocular itching.
Finally, immunotherapy (vaccines) is the only therapy that modifies the natural course of allergic disease and provides etiological treatment of the disease. The time of administration will be long term (3-5 years) and its efficacy will be measured according to the improvement of the symptomatology and the reduced use of medication.
When should a patient with allergic rhinitis undergo surgery?
When conservative medical management does not achieve sufficient improvement, anatomical alterations potentially correctable by surgery should be ruled out. For this it is essential to perform a nasal endoscopy.
Surgery in allergic rhinitis can contribute to the dynamic functioning of the nasal airway, relieving symptoms, as well as achieving greater access and distribution of drugs in the nasal cavity.
It is usually focused on the treatment of the inferior turbinate (turbinoplasty) and the correction of nasal septal deviation when it is obliterating.