This document summarizes nasal allergies and sinusitis. It describes the symptoms and causes of seasonal and perennial nasal allergies. Common allergens include pollen, mold, dust, and mites. Nasal polyps can develop from chronic allergies and cause nasal obstruction. Sinusitis is inflammation of the sinus cavities and can be acute (less than 3 months) or chronic. Acute sinusitis is usually caused by viral or bacterial infections. Chronic sinusitis causes long-term symptoms and may require surgery.

1. Nasal Allergy

2. • It is an immunoglobulin E (IgE)-mediated
immunologic response of nasal mucosa to
air-borne allergens and is characterised by
watery nasal discharge, nasal obstruction,
sneezing and itching in the nose. There
may also be associated itching in the eyes,
palate and pharynx.

3. Two clinical types
• Seasonal
• Perennial

4. Seasonal
• Symptoms appear in or around a particular
season when the pollens of a particular
plant, to which the patient is sensitive, are
present in the air.

5. Perennial
• Symptoms are present throughout the
year

6. Aetiology
• Inhalant allergens are often the cause.
Pollen from the trees and grasses, mold
spores, house dust, debris from insects or
house mite are common offenders.
• Genetic predisposition play an important
part.

7. Symptoms
• Irritation and itching of nose.
• Sneezing, 10-20 sneezes at a time.
• Nasal obstruction.
• Watery nasal discharge.
• Decreased or loss of smell.
The duration and severity of symptoms may
vary with the season.

8. signs
• Chronic cough.
• Impairment of hearing.
• Congestion and oedema of mucosa.
• Colour of mucosa over turbinates may
vary from pale to bluish or dull red.
• Retracted tympanic membrane .

9. Complications
• Recurrent sinusitis.
• Nasal polyps.
• Serous otitis media.
• Bronchial asthma. Patient of nasal allergy
have four times more risk of developing
bronchial asthma.

10. Diagnosis
• A detailed history and physical
examination is helpful, and also give clue
to the possible allergen.
• Other causes of nasal stuffiness should be
excluded.

11. Treatment
• Avoidance of allergen
• Treatment with drugs
• immunotherapy

12. Nasal polyps
• Nasal polyps are non-neoplastic masses
of oedematous nasal or sinus mucosa.

13. Two main varieties
• Bilateral ethmoidal polyps
• Antrochoanal polyp

14. Antrochoanal polyps
• Antrochoanal polyps arise from the
maxillary sinuses and are much less
common.
• Antrochoanal polyps are usually single
and unilateral .

16. Ethmoidal polyps
• Ethmoidal polyps arise from the ethmoidal
sinuses.
• Ethmoidal polyps are multiple and
bilateral.

18. Differences of ethmoidal polyps
and antrochoanal polyp
Ethmodial polyps
• It is seen in adults
• Usual cause is allergy
• Multiple like a bunch of grapes
• Bilateral mostly
• Arises from ethmoidal labyrinth
• Seen first on anterior rhinoscopy
• Recurrence is common
• Treatment is polypectomy and
ethmoidectomy in cases of
recurrence
Antrochoanal polyp
• Seen in children and adolescents
• Cause is infection
• Single mass
• Unilateral
• Origin from mucosa of maxillary
sinus
• Seen first on posterior rhinoscopy
• Recurrence uncommon
• Treatment is polypectomy

19. Symptoms of ethmoidal polyps
• Nasal block
• Sinusitis
• Anosmia (that is, loss of smell)
• Headache
• Sneezing and watery discharge
Despite removal by surgery, nasal polyps
are found to recur in about 70% of cases.

20. Symptoms of antrochoanal polyp
• Unilateral nasal block
• Voice become thick and dull
• Nasal discharge mostly mucoid

21. Sinusitis
• Sinusitis is the inflammatory condition
mucous membrane lining of the sinuses.

22. Acute sinusitis
• Acute inflammation of sinus mucosa is
called acute sinusitis.

23. • The sinus most commonly involved is the
maxillary followed in turn by ethmoid,
frontal and sphenoid.
• Pansinusitis : all the sinuses of one side
are involved .
• A sinusitis may be ‘open’ or ‘closed’ type.
• A closed sinusitis cause more severe
symptoms and is also likely to cause
complication.

24. Aetiology
• Infection
• Pharyngeal infection
• Tooth infection
• Swimming and bathing
• General diseases

25. Bacteriology
• Most cases of acute sinusitis start as viral
infections followed soon by bacterial
invasion.

26. Viruses
• Rhinovirus
• Parainfluenzae

27. Bacteria
• Pneumococci
• Streptococci
• Staphylococci

28. Pathology of sinusitis
• The mucous membrane passes through all
the usual stages of infection.
• Catarrhal stage, exudative stage,
suppurative stage, stage of complications
and stage of resolution.

29. Clinical features
• General symptoms
• Local symptoms
• signs

30. General symptoms
• Malaise
• Headache
• Fever
• Sore throat
• Facial pain

31. Local symptoms
• Feeling of discomfort in postnasal space
• Nasal obstruction
• Loss of sense of smell
• Nasal or postnasal discharge or drip
• Cough
• Pain in the sinuses

32. Points of the tenderness
• Maxillary sinus pain: over the antrum,often
with aching in the upper teeth
• Ethmoidal pain: it is localised over bridge
of the nose and between the eyes
• Frontal pain: it is localised to forehead
• Sphenoid pain: pain may be felt behind the
eyeball

33. Signs
• The mucosa of the nasal cavity will be
reddened and swelling
• The middle meatus will be closed, or a
trickle of pus will be seen coming from it
• The pus will be seen from the olfactory
sulcus or above the posterior end of the
middle turbinate.

34. treatment
• Antibiotics
• Local decongestants
• Analgesics

35. Chronic sinusitis
• It is a chronic inflammation of mucous
membrane which has resulted in
irreversible.
• Duration of symptoms is more than 3
months.

36. aetiology
• Chronic sinusitis follows acute sinusitis.

37. Clinical features
• Nasal obstructions
• Postnasal drip
• Loss the sense of smell
• Headache
• Cough
• Hoarseness of voice

38. Signs
• It shows red swollen mucosa with pus in
the involved nasal cavity.
• Pus may be seen in the pharyngeal back
wall.

39. Treatment
• Surgical management