(Posted:31-May-2015)

Nasal allergy is usually mediated by IgE when comes in contact with specific antigen,producing antigen-antibody reaction with adverse pathological consequences. Ateiology of Nasal Allergy: 1.Predisposing factors: Hereditary,emotion and anxiety,endocrinal,temperature variartion and seasonal changes. Precipitating factors: Inhalation of pollens,smokes,dust,car exhaust,house dusts,powders,tobacco smoke,animal excreta. Ingestants:Eggs,crabs,prwns,,pineapples,brinjals,milk products etc. Infection:Bacterial allergy. Drugs:Aspirin,iodide,antibiotic,etc. Synthetic materials Pathology: a)Oedema of the submucosal tissue by allergic fluid. b)Infiltration of eosinophils and plasma cells. c)vascular dilatation causes more engorgement of inferior turbinate. d)Increased activity of the the sero-mucinous glands. e)in some cases polyp formation occurs. Clinical features: a.Clear watery discharge which is profuse in amount. b.nasal obstruction c.Heaviness head and headeche occurs if associated sinusitis is present. d.There may be associated irritation and congestion of eyes,respiratory distress, and bronchospasm. e.on anterior rhinoscopy,nasal mucosa is oedematous,palgray and boggy in appearance on both sides with thin mucoid discharge. Diagnosis: 1.Carefull history. 2.Blood count may show eosinophilia 3.Provocative food test 4.Nasal provocative test. 5.Patch test 6.Allergic skin test 9. Plasma reactive immunosorbant test 10.Skin end point titration test.. Treatment: A)Prophylactic treatment: Pricipitating factors should be avoided. Hyposensitization by vaccine. Sodium chromoglycate as spray which helps to control allergic attack. Immunotherapy B)Curative treatment: •Oral antihistamin, First generation of antihistamin -Pheniramine maleate,chlorpheniramine maleat,promethazine,cyproheptadin. Second and third generation antihistamines are Cetirizin,loratadin,and fexofenadin. •Nasal decongestants •Steroid.. •General body nutrition is to be improved.Vitamin C and vitamin B complex is to be administered. B)Surgical treatment: a)Minor surgery:Reduction of nasal turbinates is often undertaken in cases of persistent nasal obstruction by following methods: *surface electro-cautery *submucosal diathermy. b)other nasal surgery:Surgery is usually avoided in cases of allergy.But in some obstructive case if deviation of septum is present,S.M.R operation along with submucosal diathermy helps the patient.If allergic polyps are present,they are removed surgically.