Allergic Rhinitis In Children

Introduction

This paper discusses the two types of rhinitis which are allergic and non-allergic and how rhinitis affects the dentition, jaw growth, dental occlusion, and behavior. Rhinitis in adults is discussed as well as the effect of rhinitis on children.

Allergic Rhinitis

Allergic rhinitis affects more than 1.4 billion people worldwide and is the condition where the immune system recognizes an intruder which in this case is called an allergen. The immune system releases histamine and chemical mediators in response to the allergen, and the nose, eyes, ears, throat, skin and roof of the mouth may experience symptoms. Pollen in the air causes seasonal allergic rhinitis (hay fever) which will depend on the time of year as well as the location.

Children with nasal blockage will typically have more of these symptoms. In a study conducted in Thammasat University Hospital it was found that in children with allergic rhinitis there is a higher prevalence of sleep problems that in those without allergic rhinitis.

Allergic rhinitis (allergies) may occur year-round or seasonally. Airborne particles from trees, outdoor mold, grass, or ragweed can be seasonal causes. Indoor substances such as indoor mold, dust mites in bedding, mattresses, and carpeting, pet dander, and cockroaches can cause year-round allergic rhinitis [1].

Non-Allergic Rhinitis

Non-IgE-dependent events associated with periodic or perennial symptoms of rhinitis characterize non-allergic rhinitis. It is different than allergic rhinitis because it does not involve an immune system response.

At least thirty percent of people with rhinitis symptoms do not have allergies. Non-allergic rhinitis usually affects adults and causes year-round symptoms, especially runny nose and nasal congestion.

Clinical

Few studies have addressed the issue of alleviating symptoms of pediatric chronic rhinitis or allergic rhinitis following adenoidectomy alone. There is a retrospective chart review study that was done to determine whether chronic rhinitis in children improves after adenoidectomy and whether children with allergic rhinitis will benefit more than those with non-allergic rhinitis. Charts of 47 children who had undergone adenoidectomy for nasal obstruction and chronic middle ear effusion were reviewed. Allergic rhinitis and non-allergic rhinitis subgroups were classified based on symptoms, signs, blood IgE, and nasal smear (allergic criteria). Hypertrophic adenoids were graded using the adenoid-to-nasopharyngeal ratio (ANr >0.8). A questionnaire was used to assess the change in chronic rhinitis postoperatively. Improvement in chronic rhinitis was reported in 37 of 47 (79%) children. Patients with allergic rhinitis improved to a higher extent than those with non-allergic rhinitis (12 of 14 [86%] vs. 25 of 33 [76%], respectively), but the difference was not statistically significant. A total of 41 lateral postoperative nasopharyngeal x-rays were obtained. The x-rays revealed that 20 of 26 (77%) of patients with ANr >0.8 had complete and 4 of 26 (15%) had partial resolution of symptoms of CR for