Rhinitis,Sinusitis,and Their Relationships to Allergies

To investigate the relationship between allergic rhinitis and sinusitis, a review of all patients seen at an outpatient suburban otolaryngology clinic was performed. Three hundred ninety-three of the 1846 (21.3%) new patients seen over an 18-month period presented with nasal complaints. Ninety-two patients had documented allergy associated rhinitis. Thirty-seven patients had strong allergic histories without allergy testing. Two thirds had worsening nasal-sinus symptoms with allergen exposure; 82% of those with seasonal symptoms noted such a relationship compared with 32% of those with nonseasonal symptoms. There was 100% correlation of the onset of acute sinusitis with worsening allergies in the allergic group, although patients with chronic sinusitis and allergies noted worsening of sinusitis with allergen exposure in only 50%. Hyposmia/anosmia or asthma were good predictors of allergies in patients presenting with nasal or sinus complaints. Sixty percent of the confirmed allergic patients responded well to medical management alone. Patients with chronic sinusitis, with or without nasal polyps, tended to respond more poorly than did the entire group to medical management alone but did better with surgical therapy.