Management of allergy and sinusitis

Allergic diseases are inflammatory disorders that occur chronically because of immune system activation by environmental factors or allergens. They are classified as type I hypersensitivity reactions mediated by Immunoglobulin E (IgE) antibodies. Atopy refers to the increased sensitivity of IgE antibodies to a specific antigen, with genetic predisposition being one of the risk factors. The clinical relationship between allergy and rhinosinusitis is not clear; however, rhinosinusitis is a result of the inflammation of the sinus mucosa due to the presence of an allergen, and it is either acute or chronic. Rhinosinusitis is, therefore, recognised as an inflammatory disorder of the paranasal sinuses and the nasal cavity. Acute rhinosinusitis (ARS) is usually caused by a viral infection, whereas chronic rhinosinusitis (CRS) is an inflammatory disorder with increased expression of cytokines. Treatments are aimed at reducing mucosal inflammation, thinning and clearing mucus, controlling infection, and treating symptoms such as nasal congestion, rhinorrhoea, sneezing and nasal itching. The goal of this article is to outline the current management approach for rhinosinusitis and review new treatment options and therapeutic techniques.