Vincent Cumberworth BSc FRCS Consultant Ear, Nose and Throat Surgeon

Vincent Cumberworth BSc FRCS Consultant Ear, Nose and Throat Surgeon

Clementine Churchill Hospital Sudbury Hill Harrow Middlesex HA1 3RX
Private Secretary: Tel: 020 8872 3866 Fax: 0208872 3861

Information is supplied only upon the condition that the viewer will make their own determination as to the suitability of the information for its purposes prior to use. There will be no responsibility for information that is misused or misinterpreted and the information should not be used as a substitute for consultation with a health care professional. It is not possible to answer questions regarding individual cases or to enter into individual correspondence.

ALLERGIC RHINITIS

Allergic rhinitis involves attacks of nasal blockage with sneezing and rhinorrhoea. It may be seasonal such as hayfever when, allergens can involve grass and tree pollen or perennial when house dust mite and animal fur may be a factor.

The lining of the nose swells with contact with the responsible allergen and there is increased production of mucus. This leads to increased discharge and blockage and there may also be a watery discharge from the eyes leading to facial symptoms such as headache and facial discomfort.

It is possible to identify the responsible allergen then avoidance can be possible.

Review by your doctor or ENT Surgeon may be necessary and sometimes skin or blood testing can be performed to identify an allergen.

Nasal spray involving topical steroids can be beneficial and also antihistamines can be used either topically or systemically to reduce the symptoms.

As well as the specific areas outlined above, avoidance of smoky environments, paints and air pollutants can also be beneficial.

House Dust Mite

House dust mites live on human skin scales and moulds wherever these are allowed to collect. They specially favour the folds in mattresses, feather pillows, thick carpets and old soft articles, such as toys. They can breed only at over 50C humidity and they prefer a temperature of around 25C. What manages to enter our airways is not the mite itself but its faecal pellets, which are light enough to become airborne and small enough to enter the airways.

Regular cleaning of bedrooms and avoiding materials particularly likely to collect dust are worthwhile measures to keep down the allergenic load.

Mites prefer to live in natural fibres. Artificial fibres should be used for all bedding, carpet and curtains in the bedroom. They should also be used to fill the duvet. Avoid Venetian blinds and padded headboards – a perfect home for mites.

1. Each week thoroughly vacuum the mattress, pillows, and around the base of the divan. Pay particular attention to around the buttons which is where the mites like to live.

Unfortunately, household vacuum cleaners can leak dust back into the atmosphere and mites migrate back into the furnishings. Use a disposable bag. Remove it immediately after use and dispose of it in an outside bin.

There are air cleaners/filters available which can remove airborne dust particles.

Washing bed clothes at a high temperature (60^oC) may be beneficial.

2. Air conditioners can prevent the high heat and humidity which stimulates mite growth. Special filters can be added to help trap the airborne allergens.

3. Ionisers will help to improve the quality of indoor air by restoring the balance of negative ions and removing dust, pollen and smoke from the atmosphere.

4. Enclose the pillows, mattress top surface and sides in either a plastic cover or with specially made bedding to form a protective barrier, ideally an allergen proof cover.

5. Each week, throughout the house, wipe all surfaces including pelmet tops, top of door frames, skirting boards etc. with a damp duster to avoid spreading the dust. Wash light curtains and soft toys regularly in a machine. Particular attention should be directed at removal of dust from upholstered furniture. Vacuum at least twice a week, especially the headrest, arms and edges of the seats. If curtains are present, regular cleaning or washing may help; blinds may need to be dusted or vacuumed. Soft toys should be removed. Alternatively, I have been advised that freezing them in a sealed plastic bag may reduce house dust mites.

6. Consider hard flooring and give particular attention to dusting blinds.

While these measures will not eliminate the House Dust Mite, they will reduce exposure to the type of dust, which causes wheezing.

Tree and Grass Pollen

Pollens from different plants vary with the season and time of year.

1. Check press for high pollen counts.
2. Keep windows shut in cars and offices.
3. Beware that pollen is highest in the early morning and early evening.
4. Avoid open grassy places.

Cat and Dog Dander

It can be difficult to remove a pet from the home and protein from saliva can remain in a house for many months.

1. Attempt restriction of pets to certain parts of the rooms and completely avoid bedrooms.
2. Consider washing the cat.
3. Again, it is easier to remove allergens from wooden and lino floors than the carpets.

Application of Nasal Drops

It is easier to put drops into the nose with the head tilted back. If you are able to put them in with the head tilted forward then they will coat the important areas of the nose physiologically as they enter the nose. If you insert with your head back ultimately they tend to run down the back of the throat and may avoid the higher areas of drainage in the nose. Even if some drops run out from a head forward insertion, it is likely that they will have bathed the relevant areas first.

Three ways in which this can be achieved are:

1. Lying face down across the edge of a bed with the head hanging downwards.
2. Curling up in the “Mecca” position on the floor so that your head is upside down.
3. Lying on your back with your head hanging back almost vertically so that the drops will run along the upper part of the nose on their way in rather than the floor of the nose.