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Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With unfortunate high frequency, clinicians consider allergic rhinitis to be more of a nuisance than an illness. When in fact, allergic rhinitis is not only a very common disease process, affecting up to a cumulative frequency of 42% of the U.S. population by age 40, but can lead to significant short-term and long-term medical complications. Poorly controlled symptoms of allergic rhinitis may contribute to sleep loss, secondary daytime fatigue, learning impairment, decreased overall cognitive functioning, decreased long-term productivity and decreased quality of life. Additionally, poorly controlled allergic rhinitis may also contribute to the development of other related disease processes including acute and chronic sinusitis, recurrence of nasal polyps, otitis media/otitis media with effusion, hearing impairment, abnormal craniofacial development, sleep apnea and related complications, aggravation of underlying asthma, and increased propensity to develop asthma. Treatment of allergic rhinitis with sedating antihistamine therapy may result in negative neuropsychiatric effects that contribute to some of these complications. Sedating antihistamines may also be dangerous to use in certain other settings such as driving or operating potentially dangerous machinery. In contrast nonsedating antihistamines have been demonstrated to result in improved performance in allergic rhinitis.
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PMID:Complications of allergic rhinitis. 1047 18

Various diseases of the upper airway, such as acute or chronic sinusitis, otitis media, pharyngitis or laryngitis, snoring and sleep apnea syndrom, may be associated with allergic rhinitis. The relationship between these pathologies and the allergic rhinitis has been well established from a clinical and epidemiological point of view, but the pathophysiological mechanisms remain uncertain. A good knowledge of symptoms and the performance of explorations, such as nasal endoscopy for sinusitis, are important in order to take care of these associated diseases. When upper airway diseases are associated with allergic rhinitis, treatment of rhinitis must generally be reinforced. Treament of associated disease will be specific to each disease, and sometimes surgery is required, specially in case of chronic sinusitis. In all cases, the pneumologist, allergologist and ENT physician should work in close collaboration.
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PMID:[ENT diseases associated with allergic rhinitis: a review of the literature]. 1086 2

Objective To develop a clinical consensus statement on the use of sinus ostial dilation (SOD) of the paranasal sinuses. Methods An expert panel of otolaryngologists was assembled to represent general otolaryngology and relevant subspecialty societies. The target population is adults 18 years or older with chronic or recurrent rhinosinusitis (with or without nasal polyps, with or without prior sinus surgery) for whom SOD is being recommended, defined as endoscopic use of a balloon device to enlarge or open the outflow tracts of the maxillary, frontal, or sphenoid sinuses, as a standalone procedure or with endoscopic surgery. A modified Delphi method was used to distill expert opinion into clinical statements that met a standardized definition of consensus. Results After 3 iterative Delphi method surveys, 13 statements met the standardized definition of consensus while 45 statements did not. The clinical statements were grouped into 3 categories for presentation and discussion: (1) patient criteria, (2) perioperative considerations, and (3) outcomes. Strong consensus was obtained for not performing SOD in patients without sinonasal symptoms or positive findings on computed tomography (CT) in patients with symptoms only of headache or sleep apnea without criteria for sinusitis. In addition, strong consensus was met that CT scan of the sinuses was necessary before performing SOD and that surgeons need to understand and abide by regulations set forth by the US Food and Drug Administration if they choose to reuse/reprocess devices. Conclusion Expert panel consensus may provide helpful information for the otolaryngologist considering the use of SOD for the management of patients with a diagnosis of rhinosinusitis. This panel reached consensus on a number of statements that defined the use of SOD as inappropriate in the management of a variety of symptoms or diseases in the absence of underlying sinusitis. When patients meet the definition of chronic sinusitis as confirmed by CT scan, SOD of the sinuses can be indicated and/or effective in certain scenarios. Additional consensus statements regarding proper setting and safeguards for performing the procedure are described.
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PMID:Clinical Consensus Statement: Balloon Dilation of the Sinuses. 2938 3