Eighty consecutive patients presenting with variable nasal symptoms were investigated. Fifty-three (66.25%) were identified as allergic and 27 (33.5%) as having nonallergic rhinitis. Medical history and clinical examination alone seemed to be inadequate in establishing a diagnosis, since the main complaints, i.e., nasal itching, sneezing and runny nose, occurred with the same frequency in both groups. However, alternating nasal blockage and sneezing were more prominent in the allergic group (80.40%), while perennial symptoms were more evident in the nonallergic group (68%). There were no striking differences between the two groups in the occurrence of nasal septal deviation or in evidence of nasal polyps. In the allergic groups, sensitivities to indoor allergens, i.e., cockroaches, cat fur, house dust, as well as to pollens, were very prominent. Among the nonspecific provoking factors, dust, strong smells, smoke and stress seem to be important. Ann Saudi Med 1996;16(5) Patients with acute, recurrent or chronic nasal complaints continue to make up a large percentage of those seeking medical attention. The common presenting complaints are sneezing, runny nose, nasal itching and nasal obstruction. These are sometimes associated with secondary features involving the conjunctiva, oropharynx, middle ear, paranasal sinuses or general complaints of headache, malaise or irritabilities.1,2 Approximately 20% of patients with nasal symptoms are thought to suffer from nonviral rhinitis, of which 50% is probably allergic in origin. 3,4 Although there is usually no radical cure for these conditions, in most cases effective control of symptoms can be achieved once the type of rhinitis has been identified.In the majority of cases of rhinitis, specific and nonspecific environmental stimuli trigger the symptoms. These include allergens, temperature changes, odors, air pollutants, emotional upset or recumbency. Therefore, a comprehensive medical, environmental and lifestyle history is essential in establishing a specific trigger of patient symptoms. In most cases, a clue to the diagnosis can be reached, which is then further confirmed by appropriate investigations. This is the traditional approach because there is no satisfactory method for measuring nasal function. 5,6 The present study was undertaken in view of the changing nature of the Saudi environment, brought on by extensive agricultural and horticultural advances. The objective was to compare our findings with earlier studies 7,8 and examine any change in the pattern. Moreover, we compared the frequency of presenting complaints in the allergic and nonallergic group, as well as the role of specific and nonspecific factors.
Patients and MethodsEighty consecutive patients, 45 males and 35 females, presenting with variable nasal symptoms to the ENT clinics at King Abdulaziz University Hospital (KAUH) and King Khalid University Hospital (KKUH) were included in this study.A comprehensive clinical history was taken from all patients, through a questionnaire. Clinical examination i...