EVALUATION AND MANAGEMENT OF ALLERGIC RHINITIS - 07/09/11

Doi : 10.1016/S0025-7125(05)70084-5

James A. Hadley, MD, FACS ^{^{*
Department of Otolaryngology, University of Rochester Medical Center, Rochester, New York}}

Résumé

Allergic rhinitis is a common ailment that affects up to 40 million Americans regardless of age, sex, race, or socioeconomic status. It is characterized as an immunologic response giving rise to symptoms of excessive sneezing, rhinorrhea, and bothersome nasal congestion, which may be seasonal or constant throughout the year.^{17 Mygind N., Anggard A. Anatomy and physiology of the nose—pathologic alterations in allergic rhinitis Clin Rev Allergy 1984 ; 2 : 173-188

Cliquez ici pour aller à la section Références, 18 Naclerio R.M. Allergic rhinitis N Engl J Med 1991 ; 325 : 860-869

Cliquez ici pour aller à la section Références} Almost one half of new patients evaluated by an otolaryngologist have a chief complaint partially related to upper respiratory allergies. One study^{19 Nathan R.A., Meltzer E.O., Selner J.C. , et al. Prevalence of allergic rhinitis in the United States J Allergy Clin Immunol 1997 ; 99 : S808-S813

Cliquez ici pour aller à la section Références} estimated that the prevalence of allergic rhinitis in the US population is 14.2% and is increasing. The problems encountered by the patient suffering from allergies are widespread and may adversely affect other organ systems as well. It is important for the practicing physician to become familiar with the evaluation and management of this common disorder.

The otolaryngologist is frequently called on to evaluate these complaints because the nose is usually the first site of a hypersensitivity response.^{24 Trevino R.S., Gordon B.R. Allergic rhinosinusitis: The total rhinologic disease Ear Nose Throat J 1993 ; 72 : 120-129

Cliquez ici pour aller à la section Références} Allergic rhinitis is not the only common problem evaluated by the otolaryngologist. Rhinosinusitis, otitis media, sleep disorders, asthma, and nasal polyps are encountered as well.^{3 Benninger M.S. Rhinitis, sinusitis, and their relationship to allergies A J Rhinol 1992 ; 6 : 37-43 [cross-ref]

Cliquez ici pour aller à la section Références} Complications of inhalant allergy lead to a general decline in the health of the individuals affected and may be responsible for a significant reduction in overall productivity. Adults have reduced productivity at work and children are frequently ill, missing time from school and placing a burden on parents that work because of their frequent physician office visits.^{1 Adams P.F., Marano M.A. Current estimates from the National Health Interview Survey, 1994 Hyattsville MD: National Center for Health Statistics (1995).
US Dept of Health and Human Services Publication (PHS) 96-1521. Series 10, No. 193..

Cliquez ici pour aller à la section Références, 20 Nolen T.M. Sedative effects of antihistamines: Safety, performance, learning, and quality of life Clin Ther 1997 ; 19 : 39-55 [cross-ref]

Cliquez ici pour aller à la section Références}

Treatment outcomes are important for managed care initiatives. Chronic conditions such as allergic rhinitis have a direct impact on the use of health care services. The benefits of therapy for symptoms of allergic disorders include improved health for the individual with resultant reduction in the use of health care resources, especially for urgent or specialist care. The goal is to decrease the complications of allergic rhinitis, such as recurrent or chronic rhinosinusitis, chronic otitis media with effusion, and asthma.

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