Colds, allergic rhinitis, rhinopharyngitis, sinusitis

Colds : the starting point for ENT infections ?

A cold is a generic, non-medical term encompassing all acute nasal conditions, i.e., those which last only a few days, as opposed to chronic conditions. The common cold starts out as a simple rhinopharyngitis.
Colds are often caused by viruses.
Children under age 4 have an average of 8 colds a year, older children have 4 or 5 colds a year and young adults 2 or 3 a year.

How do colds impact our quality of life ?

Having a cold is not as innocent as it seems because colds can make life pretty miserable.
Common symptoms include nasal congestion, sneezing, sore throat, cough, feeling unwell, shivers, runny nose and headache.
94 % of cold sufferers say their colds interfere with sleep and 87 % say they interfere with social activities.

What are the possible complications of a cold ?

A run-of-the-mill cold can turn into acute otitis media, acute sinusitis, an asthma attack or acute bronchitis.
This is even more likely to occur in people who have allergies, asthma, who smoke or who breathe through their mouths.
The ideal thing to do is to break the vicious cycle initiated by the cold so that it does not develop into rhinopharyngitis or rhinosinusitis.

ALLERGIC RHINITIS : What causes it ?

Are you an allergy sufferer ?

If it offers any consolation, you are not alone : 24 % of the population suffers from allergies of one kind or another : to animal hair, house mites, dust, pollen, food or other products...

Epidemiological studies have shown that the frequency of such allergies has doubled over the last 30 years.

Allergic rhinitis has many causes, but the main ones are :

The deterioration in our environment, in particular the rise in air pollution,
the increasing confinement of the houses we live in (the energy crisis led to improved home insulation, but at the expense of an increased density of domestic allergens).

The World Health Organisation now ranks allergy as the 4th most common pathology worldwide. 30 % of the population has already had some sort of allergic condition. Some estimates predict that this proportion will rise to 50 % between 2035 and 2050.

Allergic rhinitis is caused by exposure of the nasal mucosa to inhaled allergens such as pollen, house dust, house dust mites, etc.

There are two types of allergic rhinitis :

Seasonal rhinitis (also known as « pollinosis » or « hay fever ») which is closely linked to the pollen calendar. Of the 20 % of the population affected by allergies, 75 % are allergic to pollen. The months with the highest pollen counts are April to June, with the herbaceous plants such as rapeseed and the gramineous plants such as hay in full flower. But plane, birch and poplar trees, as well as linden and privet in July, can also trigger allergies.
Aperiodic (or perannual) rhinitis is caused by non-seasonal allergens present all year round. Allergens include house dust mites, cockroaches and mould, which flourish in warm, damp conditions, and also animal hair. Close to 2.5 % of the population is allergic to pets, with cats topping the chart.

Certain individuals are what is termed polysensitised, meaning that they suffer from both seasonal allergies (e.g. to pollen) and paperiodic allergies (e.g. to dog hair).

How does allergic rhinitis occur ?

2 phases :

Phase 1 :

Sensitisation (first exposure) to the allergen.

The allergen comes into contact with the individual. The organism mounts an immune response to it. In the course of this initial exposure, the individual produces antibodies (mast cells) which are able to recognise the allergen concerned. These antibodies then fix onto the nasal mucosa.

Phase 2 :

Second exposure to the allergen.

When contact next occurs, the allergen encounters the mast cells and triggers a reaction, causing the release of inflammatory factors like histamine.

This inflammatory reaction then in turn triggers :

hypersecretion of mucus and swelling of the nasal mucosa due to inflammation that can, at worst, obstruct the airways,
frequent sneezing,
red, watery eyes,
diminished sense of smell.

When you use STÉRIMAR, you rid your nose of allergens, reduce the congestion of the nasal mucosa, reduce the volume of mucus and thus restore optimum nasal function.

What are the complications of allergic rhinitis ?

A blocked nose can interfere drastically with your sleep.
The chronic discomfort is incapacitating, especially the phenomenon of a constantly running nose, and can only be combated by the use of antihistamines, many of which risk causing drowsiness. Users are thus at risk of being less alert and attentive at crucial moments (at the wheel, at work, during final exams, etc.).
Asthma, often associated with allergic rhinitis (a trigger factor), is the most serious associated event.

The WHO estimates that there are currently 300 million people with asthma worldwide. Asthma is the most common chronic disease in childhood.

In 2002, the WHO published its ARIA report (Allergic Rhinitis and its Impact on Asthma).

The report’s objective :

To draw up an inventory of the incidence of allergic rhinitis,
To adopt a strategy of asthma prevention by providing for better treatment.

The report shows that 80 % of asthma sufferers presented with previous incidence of rhinitis.
Better treatment could have avoided aggravation of the condition and its subsequent evolution.
As a result, asthma and allergies have been identified by the WHO as public health priorities.

Rhinopharyngitis

What is rhinopharyngitis ?

Rhinopharyngitis is an acute or chronic inflammation of the mucous membranes in the nose and throat.
This provides a favourable terrain for the development of inflammation and microbial infections.

What causes rhinopharyngitis ?

Rhinopharyngitis is usually caused by a virus (viral infection); viruses are more common in cold weather and strike in the form of small epidemics. Cold and fatigue are contributing factors.

What are the symptoms of rhinopharyngitis ?

The early symptoms of rhinopharyngitis are :

red, inflamed throat (pharynx),
runny and blocked nose,
sneezing,
feeling generally unwell,
sometimes accompanied by headaches,
feverishness (especially frequent in children) sometimes with a very high temperature for 2 to 3 days,
trouble with breathing, reduced sense of smell,
tickling sensation in the nose and throat,
sensations of pins and needles and constriction (tightness) may also be felt.

Is rhinopharyngitis contagious ?

Infectious rhinopharyngitis (caused by microbial or viral infection) is contagious, unlike allergic rhinitis.

How is rhinopharyngitis transmitted ?

Rhinopharyngitis is transmitted as an aerosol, i.e. in particles of liquid (saliva or nasal secretions) suspended in air breathed out by infected individuals. Droplets of saliva, for example, suspended in the air during a conversation or as the result of sneezing, can transmit the germs.

How long can the virus or bacteria live outside the human body ?

The lifespan of the germ outside the human body can range anywhere from several minutes to several hours.

How should rhinopharyngitis be treated ?

The use of antibiotics is not recommended because they have no effect whatsoever at this stage. Antibiotics are effective against bacteria, but they have no effect on rhinopharyngitis which is caused by a virus.

What can be done to get rid of it ?

Blow your nose to clear the secretions blocking it,
Systematically cleanse the nose with sea water.

What are the complications of rhinopharyngitis ?

Although benign in principle, complications can arise with the pharynx providing a point of entry for the infectious agent. In most cases the body’s immune system, coupled with basic local treatment, are enough to prevent the infection developing.

If nothing is done, however, secondary infection may set in or the infection may spread into the ENT sphere for the simple reason that the ears, nose and throat are all interconnected :

Sinusitis, especially in adults, is a classic complication, with its associated pains, feverishness and headaches.
Ear infection in children, acute, painful or febrile; in adults, serous otitis which causes inflammation and produces a sensation of blocked ears.
Laryngitis is another infectious complication, affecting the airways, that is associated with rhinopharyngitis. It can cause modification or loss of voice or even breathing problems, especially in children, due to the spread of the inflammation caused by the virus. Tissues swell and can cause suffocation.
Finally, and most serious, is acute or chronic bronchitis, a complication which can arise from all these viral or bacterial infections.

Rhinopharyngitis and its complications are part and parcel of the range of infantile diseases. Once the child’s immune system has reached maturity, around the age of 3, the incidence of rhinopharyngitis tends to diminish.

Sinusitis

What is sinusitis ?

Sinusitis is an inflammation of the sinuses, cavities in the facial bones. The infection may be caused by bacteria or viruses.
Today, the condition is now known more precisely as rhinosinusitis

What are the symptoms of sinusitis ?

Sinusitis is characterised by :

complete blockage of a nasal fossa,
abundant and purulent (yellow) nasal secretions, with mucus present in the back of the throat, a sign of bacterial infection,
more or less generalised pain affecting the forehead or face, at the level of the frontal or maxillary sinuses,
a reduction in or loss of the sense of smell,
temperature of 38°C or above (not always present).

What causes sinusitis ?

The sinuses are closed cavities connected to the nose through a small orifice known as the meatus. The 15,000 liters of air that we breathe in every day are first filtered, warmed and moistened by the nose before passing through this meatus. When the nasal mucosa is congested, air no longer reaches the sinuses,which then offer favourable terrain for the development of bacteria and hence for infection.

Potential causes :

a common cold not properly treated: 5 to 10 % of neglected colds turn into sinusitis.
dental procedures: the molars and premolars in the upper jaw are close to the maxillary sinuses.
There are two possible sources of infection : either the tooth is infected, or the tooth has been filled with an amalgam, part of which has then migrated into one of the maxillary sinuses.
a congenital or traumatic anatomic anomaly: a deviated septum, too narrow a meatus, nasal polyps (often allergic in origin).

What are the complications of sinusitis ?

They differ according to the localisation of the infection :

Maxillary sinusitis
Frontal sinusitis
Beware of meningeal, vascular or cerebral complications, as well as torpid frontal osteitis, extremely rare but very serious !
Sphenoidal sinusitis

Very rare (occurring in less than 1 % of cases), but the risk of damage to the optic nerve is high, as is the risk of meningitis and thrombophlebitis in the cerebral blood vessels.