Rhinitis

Rhinitis is an inflammation of the mucous membrane of sinus cavities and can be acute (common cold) and chronic. Acute rhinitis is in most cases viral. Infection occurs if direct contact between sick and healthy subject takes place, through little drops released when sneezing and coughing. The peak of infectiousness occurs on the first day of disease.

Chronic rhinitis is mostly secondary to other diseases of sinus cavities, such as sinusitis, curvature of nasal septum and enlarged adenoids.

Allergic rhinitis, starts with a series of acute onsets and by the time it becomes chronic. It is triggered off by exposure to substances this person is allergic to (allergens) such as pollens, food (eggs, milk, beverages, etc) or substances in work and home environment.

Symptomatology and progression

During a common cold, after 1-3 days of incubation, the patient feels a general indisposition with sneezing, rhinorrhea (secretion of nasal mucus) , nose obstruction and no perception of smells (anosmia). Sinus cavities are full of fluid and clear nasal mucus.

In the following days nasal mucus may become purulent, therefore thicker and foul smelling if a bacterial infection is added. If there are no complications common cold naturally comes to an end within 4-5 days.

In chronic rhinitis the sensation of nasal obstruction is persistent while hypersecretion may occur or may not.

Allergic rhinitis begins with sneezing, runny nose, nasal obstruction, anosmia, itchy nose and eyes, watery and irritated eyes. These symptoms may be seasonal (more frequent in spring and fall) or perennial (throughout the year) according to the type of allergy. Patients allergic to pollens will experience these symptoms during the season of tree and local grass pollination.

An overlooked acute rhinitis may lead to complications such as an infection of sinus cavities (sinusitis) or an inflammation of larynx (laryngitis). Allergic rhinitis may also lead to complications as sinusitis, medium otitis, nose polyps and a more serious bronchial asthma.

Chronic rhinitis, on the contrary, may become atrophic rhinitis. In this case cells producing mucus disappear and foul smelling crusts develop. The patient suffers from persistent nasal obstruction and headache.

Therapeutic methods: phototherapy

Allergic rhinitis and nasal polyposis are common nasal diseases, but the therapeutic available methods are not very effective.

Phototherapy uses red narrow-band light and low energy to treat symptoms of allergic rhinitis and nasal polyposis.

In a prospective randomized double-blind study 50 patients suffering from allergic rhinitis and 10 suffering from nasal polyposis were treated with intranasal 660 nm light therapy for 4,4 minutes three times a day for a period of 14 days (total dosage 6 joule a day). 23 patients suffering from rhinitis and a patient with polyposis were treated with simulated light therapy equal to a placebo. The assessment was based on a score relating to symptoms and to a clinical test of rigid and flexible nose endoscopy, which was video recorded before and after the treatment.

Following this treatment, the symptoms of 72% of patients suffering from allergic rhinitis showed an improvement and in 70% of these cases an objective improvement thanks to an endoscopy test, if compared to 24% and 3%, which were the percentages resulting from the group of patients treated with a placebo. These differences are important. No improvement was reported in patients suffering from polyposis.

If allergic rhinitis occurs without complications such as polyposis and chronic sinusitis, it may be effectively treated with light therapy of the nasal mucous membrane by red narrow-band 660 nm light and clinical symptoms may be considerably relieved. Possible candidates for phototherapy should be selected through endoscopy.