Rinite, sinusite e asma: indissociáveis?

Abstract

The objective of this study was to review the literature and to discuss epidemiological and physiopathological aspects and therapeutical implications of an unified approach to allergic rhinosinusitis and asthma. The bibliographic survey was based on the information provided by the following databases: Medline, MD Consult, Highwire, Medscape, LILACS and through direct search over thirty years, using the terms allergic rhinitis and asthma. Fifty-five original articles were selected in the no systematically review addressing the issue of clinical association between allergic rhinusinusitis and asthma. It is noteworthy that in the late years, with the use of specific topical medications for the lower airways or else, to the upper airways, the therapeutical approach has been distinct. However, numerous epidemiological surveys, immunopatological and clinical studies demonstrate the inter-relationship between asthma and allergic rhinossinusitis, characterized by: i) allergic rhinitis is associated to asthma and constitute an independent risk factor for its occurrence; ii) the immunopathological characteristics of allergic rhinitis and asthma are similar; iii) allergic rhinitis and asthma are manifestations of a systemic disease; iv) control of rhinitis favors asthma control. taking into consideration the close inter-relationship between allergic rhinitis and asthma, the approach to diagnosis, treatment and prophylaxis of these illnesses should be integrated. Therapeutical options that allow for the simultaneous control of asthma and allergic rhinitis offer advantages related both to costs and tolerability.

Ocorrência de rinite, respiração oral e alterações orofaciais em adolescentes asmáticos

“…Allergic rhinitis is a risk factor for the development of asthma 3,[13][14][15][16] , it is concluded, therefore, that the majority of patients with asthma have rhinitis.…”

Efeitos agudos do ultrassom terapêutico de 1-MHz na desobstrução nasal de indivíduos com rinossinusite crônica

“…1,2 Sinusitis without rhinitis is rare, but rhinitis may occur alone. Non-specific chronic infectious rhinitis is often associated with sinusitis, and should be classified and treated as rhinosinusitis.…”

“…6,7 Anatomical variations of the nasal septum, middle turbinates and uncinate process are predisposing factors because they result in stenosis and may impede ventilation, which worsens the condition. 1,7 Rhinosinusitis is usually time-defined according to frequency and duration of disease; [1][2][3][4] it is commonly classified as four subtypes: acute (sudden onset, lasting up to four weeks), recurring (over four yearly episodes with full resolution between each), subacute (persisting after four weeks and remaining for over 12 weeks, but less intensely), and chronic (persisting for over 12 weeks). 1,8 Signs and symptoms are similar in any subtype; the clinical picture is what varies.…”

“…There is rhinorrhea, significant nasal block, dry coughing that worsens at night, throat clearing, cacosmia, halitosis, hyposmia, and nasal bleeding in the chronic phase. [1][2][3][4][5][6][7][8] Predisposing factors -such as duration and frequency of crises -are relevant for defining appropriate therapy in chronic rhinosinusitis. [1][2][3][4][5][6][7][8] Recent studies have recommended using systemic or topical drugs and adjuvant therapy.…”

“…[1][2][3][4][5][6][7][8] Predisposing factors -such as duration and frequency of crises -are relevant for defining appropriate therapy in chronic rhinosinusitis. [1][2][3][4][5][6][7][8] Recent studies have recommended using systemic or topical drugs and adjuvant therapy. 1,3,8 Aspiration of nasal sinuses is indicated if hosts are immunocompromised, severely ill, or if antibiotic therapy is ineffective.…”