Secondhand smoke and rhinitis

V Brazilian Consensus on Rhinitis - 2024

Since we published the "IV Brazilian Consensus on Rhinitis", in2017, several advances have been achieved and have enabled a further understanding of the different aspects of "Rhinitis". This new guideline, developed jointly by ASBAI, SBP and SBORL, represents a relevant milestone in the updated and integrated management of the different forms of the disease, and it aims to unify evidence-based approaches to improve the diagnosis and treatment of this common and often underestimated condition. The document covers a wide range of topics, including clear definitions of the different phenotypes and endotypes of rhinitis, risk factors, updated diagnostic criteria, and recommended methods for clinical and laboratory investigation. We stress the importance of detailed clinical history and objective assessment, as well as tools for control and assessing severity tools an accurate diagnostic approach to the disease. Regarding treatment, it emphasizes the treatment customization, considering the severity of symptoms, the presence of comorbidities and the impact on the patient's quality of life. We discuss different drug treatment, in addition to non-pharmacological measures, such as environmental control and specific immunotherapy; and the possible role of immunobiological agents. Furthermore, the consensus addresses issues related to patient education, prevention and management of special situations, such as rhinitis in children, in pregnant women and in the elderly. In short, the "V Brazilian Consensus on Rhinitis" represents a comprehensive and updated guide for healthcare professionals involved in the diagnosis and management of rhinitis, aiming to improve patients' quality of life through an integrated and evidence-based approach.

The Effect of Passive Smoking on Mucociliary Clearance and Inferior Concha Reactivity

INTRODUCTION

The aim of this study is to investigate the effect of cigarette smoke on turbinate reactivity and mucociliary clearance (MCC) in passive smokers.

METHODS

60 adult patients (30 passive smokers and 30 healthy subjects as the control group) were recruited for this study. Following a questionnaire on passive smoke exposure, MCC measurement using the saccharin test was carried out to all participants. The baseline and after decongestant acoustic rhinometry values (MCA1, MCA2, VOL1, VOL2) were measured and the percentage changes between the two test values (ie; response to nasal decongestants = concha reactivity) were recorded.

RESULTS

All 60 patients, including 37 women (61.7%) and 23 men (38.3%) were between 18-57 years of age . MCC's average measurements were 11.13 minutes in the passive smokers group, 7.87 minutes in the control group, which was statistically significantly different (p < 0.05). There was a statistically significant difference between the passive smokers and control group for acoustic rhinometric measurement of the ratio of MCA2 and VOL2 values before and after decongestant application (p < 0.05).

DISCUSSION

Passive smoking can damage the nasal mucosa at least as active smoking. The number of studies on this subject is limited. There are no studies in the literature showing the effect of cigarette smoke on the inferior turbinate mucosal response. In our study, the inferior turbinate decongestant capacity was found to be significantly decreased in the passive smokers compared to the control group.

CONCLUSION

As a result of cigarette exposure, the erectile function of the lower turbines may be impaired. The task of the ENT physicians is to warn the passive smokers in this regard.

Aeroallergens, air pollutants, and chronic rhinitis and rhinosinusitis

Chronic rhinitis and rhinosinusitis are among the most common conditions worldwide with significant morbidity and decreased quality of life. Although the pathogenesis of these conditions is multifactorial, there has been increasing evidence for the role of environmental factors such as aeroallergens and air pollutants as initiating or exacerbating factors. This review will outline the current literature focusing on the role of aeroallergens and air pollution in the pathogenesis of chronic sinonasal inflammatory conditions.