Treating rhinitis in many ways is similar to treating sinusitis. Decongestants and antihistamines may be prescribed for patients with bronchial asthma who do not experience adverse excessive dryness and "plugging" of the bronchial tubes. A saline nasal mist can help provide moisture to the nasal lining. Intranasal topical corticosteroid sprays (beclomethasone, budesonide, triamcinolone, mometasone, flunisolide, fluticasone) and cromolyn sodium are extremely helpful in treating rhinitis. These agents do not produce excessive dryness and may be preferred over decongestants and antihistamines. Adverse effects of topical corticosteroid nasal sprays include minor irritation or stinging and, rarely, bleeding from the nasal lining.
What Are Nasal Polyps?
Nasal polyps are fleshy growths or extensions of the nasal and sinus lining. They are common in patients with bronchial asthma and may occur with or without allergy. They often occur in patients older than age forty who are not allergic but who have severe rhinitis. Common symptoms are constant nasal stuffiness as well as a loss or reduction of the senses of smell
and/or taste.
The importance of nasal polyps is related to their ability to block the nasal and sinus passages, which may also be the source of poor drainage of sinuses that leads to recurring sinus infections. The presence of nasal polyps in adult patients who are not allergic often identifies a more severe group of asthmatics. This group also has a greater hypersensitivity to aspirin and related medications .
Treating Nasal Polyps
Administering topical intranasal corticosteroid sprays often helps. Oral corticosteroids may be used to shrink polyps in patients with severe disease. In those who do not respond and who have severe obstructions, polypectomy should be considered. When feasible, this procedure is also being performed endoscopically. Before polypectomy occurs, the patient's asthma must be under good control, which may demand pretreatment with oral corticosteroids. Unfortunately, polyps tend to recur.
