Journal of Allergy and Clinical Immunology
Chapter 9Rhinitis and sinusitis
Section snippets
Background
Although semantically, the term rhinitis implies inflammation of the nasal mucous membranes, inflammatory cell infiltrates are not characteristic of all disorders considered to be rhinitis. As a clinical term, rhinitis refers to a heterogeneous group of nasal disorders characterized by 1 or more of the following symptoms: sneezing, nasal itching, rhinorrhea, and nasal congestion.1 Rhinitis can be caused by allergic, nonallergic, infectious, hormonal, occupational, and other factors.1, 2
Sinus anatomy and physiology
Normal sinus function requires (1) patency of each sinus ostia, (2) normal mucociliary function, and (3) normal systemic and local immune function. Epithelial cilia in the sinuses normally beat mucus in an ordered fashion toward the ostia that communicate with the nasal cavity. The maxillary, anterior ethmoid, and frontal sinuses drain through a comparatively narrow drainage pathway, the ostiomeatal unit (complex), which communicates into the middle meatus, a space between the inferior and
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Disclosure of potential conflict of interest: M. S. Dykewicz is an advisor for Alcon, Boehringer Ingelheim, and Ista; is on the speakers' bureau for Merck and Sanofi-Aventis; is on the Board of Directors for the American Board of Allergy and Immunology; is on the Board of Directors and is a member of the Rhinitis Committee for the American Academy of Allergy, Asthma & Immunology; and is Vice Chair and on the Committee on Rhinitis and Sinusitis for the American College of Allergy, Asthma & Immunology. D. L. Hamilos has received research support from Merck and the Flight Attendant Medical Research Institute and has served an as expert witness on the topics of anaphylaxis and occupational asthma.