Allergic Rhinitis and Sinusitis: Overview and Risk Factors

Allergic rhinitis is very common, affecting at least 60 million persons in the United States. Allergens cause release of chemical mediators from mast cells in the nasal mucosa. In turn, these mediators cause rhinorrhea; sinus congestion; sinus pressure (especially when leaning forward); itching that may include the eyes, palate, and nose; and sneezing. Cough results from postnasal drip, and sleep disturbance may contribute to fatigue.

Sinusitis, also known as rhinosinusitis, is an inflammatory process of the paranasal sinuses. The most common causes are viral upper airway infections and allergies. Acute bacterial rhinosinusitis is a secondary event occurring in approximately 2% of cases of viral infection.

Risk Factors

Possible risk factors for allergic rhinitis and sinusitis include:^1,2

Allergic Rhinitis

• History of atopy in patient or family.
• Male gender.
• First–born child.
• Birth during a pollen season.
• Early introduction of infant formula and food.
• Early antibiotic use.
• Maternal smoking in first year of life.
• Exposure to indoor allergens (dust mites, animal dander, mold).
• In patients less than 6 years of age, serum IgE of 100 IU/mL or greater.

Sinusitis

• Allergic rhinitis.
• Nasogastric intubation.
• Dental infection.
• Barotrauma.
• Cystic fibrosis or other ciliary abnormalities.
• Chemical irritation.
• Obstruction due to tumor, granuloma, or foreign body.