? I. Introduction to Otolaryngology

Full Name: Otolaryngology-Head and Neck Surgery
Abbreviation: ENT Department
Core Responsibility：A medical specialty dedicated to the diagnosis and treatment of diseases involving the ear, nose, throat, head and neck.

✅ Common Scope of Diagnosis and Treatment:

• Ear diseases: Otitis media, tinnitus, hearing loss, vertigo

• Nasal diseases: Rhinitis, sinusitis, nasal polyps, epistaxis, deviated nasal septum

• Throat diseases: Tonsillitis, pharyngitis, vocal cord polyps, snoring/obstructive sleep apnea

• Head and neck tumors: Thyroid tumors, laryngeal cancer, nasopharyngeal cancer, etc.

• Allergy-related diseases: Allergic rhinitis (the most common)

? Special Reminder: Although allergic rhinitis is an allergic condition, its main symptoms manifest in the nasal cavity. Therefore, the otolaryngology department is a key department for initial diagnosis and treatmentand often collaborates with the allergy department for joint diagnosis and treatment.

? II. What is Allergic Rhinitis?

? Medical Name:

Allergic Rhinitis(AR)
Also known as allergic rhinitis, it is a non-infectious inflammation of the nasal mucosa induced by allergens, belonging to an IgE-mediated Type I hypersensitivity reaction.

Simply put: Your immune system misidentifies harmless substances such as pollen and dust mites as "foreign invaders" and launches an attack, leading to nasal inflammation.

? Epidemiological Status:

• The global prevalence rate ranges from 10% to 40%, with approximately 250 million patients in China.

• It has a high incidence in children and adolescents, and the morbidity rate is rising year by year.

• It often coexists with asthma, allergic conjunctivitis and eczema.

? III. Main Symptoms (the "Four Cardinal Symptoms")

? Associated Symptoms:

• Itchy eyes, lacrimation, conjunctival hyperemia(allergic conjunctivitis)

• Itchy pharynx, cough (caused by postnasal drip irritating the pharynx)

• Hyposmia(due to nasal mucosal swelling)

• Aural fullness, tinnitus(impaired eustachian tube function)

• Dark circles under the eyes, lower eyelid swelling("allergic shiners")

? IV. Common Allergens

? Classification:

V. How to Diagnose? – Common Examinations in Otolaryngology

1. Medical History Inquiry + Symptom Assessment

• Onset time, frequency, triggers, and whether complicated with asthma, etc.

2. Anterior Rhinoscopy or Nasal Endoscopy

• Doctors observe the nasal cavity with medical instruments.

• Typical findings: Pale and edematous nasal mucosa, inferior turbinate hypertrophy, and retention of clear nasal discharge.

3. Allergen Testing

• Skin Prick Test: Rapid and accurate, with results available in 15 minutes.

• Serum Specific IgE Test: A blood test, suitable for patients with eczema on the skin or those taking medication.

4. Nasal Provocation Test(in special cases)

• Patients are exposed to allergens under close monitoring to observe nasal reactions.

5. Paranasal Sinus CT(when sinusitis or nasal polyps are suspected)

? VI. Treatment Methods (the "Four-in-One" Strategy)

Recommended by the World Health Organization (WHO): Allergen Avoidance + Pharmacotherapy + Immunotherapy + Health Education

1. Allergen Avoidance(Fundamental Measure)

2. Pharmacotherapy(Symptomatic Control)

✅ Recommended Regimen: Intranasal corticosteroids combined with oral antihistamines for a better therapeutic effect.

3. Immunotherapy (Desensitization Therapy) ✅ Curative Therapy

• Principle: The immune system is desensitized and acclimatized through long-term, repeated exposure to small doses of allergens.

• Administration Methods:

• Subcutaneous Immunotherapy (SCIT): Injections administered weekly for a 3–5 year course.

• Sublingual Immunotherapy (SLIT) Daily sublingual drops or tablets for greater convenience.

• Indicated Population: Patients with moderate to severe allergic rhinitis who refuse long-term medication.

• Efficacy: Symptomatic improvement is achieved in 70%–80% of patients, and the progression to asthma can be prevented.

4. Surgical Treatment(Adjuvant Therapy)

• Inferior Turbinate Radiofrequency Ablation: Reduces hypertrophic turbinates to relieve nasal congestion.

• Septoplasty:For patients complicated with a deviated nasal septum.

• Nasal Polypectomy: For patients complicated with nasal polyps.

⚠️ Surgery cannot cure allergy itself; concomitant medication and allergen avoidance are still required.

? VII. When to Consult an Otolaryngologist?

Seek medical attention promptly if you experience the following:

• Persistent nasal congestion, clear rhinorrhea and sneezing that impair study and sleep.

• Associated hyposmia, headache or aural fullness.

• Poor symptom control with medication and a desire to try desensitization therapy.

• Suspicion of complications such as nasal polyps or sinusitis.

? VIII. Hazards of Allergic Rhinitis (Not to Be Ignored!)

✅ IX. Summary

? Warm Reminders for Patients:

1. Do not regard allergic rhinitis as a trivial issue – prolonged neglect may lead to serious consequences.

2. Intranasal corticosteroids are safe and effective, so there is no need to worry about side effects (minimal systemic absorption with topical administration).

3. Desensitization therapy is currently the only treatment that may alter the disease course, making it ideal for long-term management.

4. Master the correct use of nasal sprays and nasal irrigators.

If symptoms occur, it is recommended to consult an otolaryngologist or allergist as early as possible. Adopt scientific prevention and control measures to bid farewell to "endless nasal discharge" and "suffocating nasal congestion"!