The link between allergic rhinitis and asthma, otitis media, sinusitis, and nasal polyps

Allergic rhinitis is the most prevalent atopic disease encountered by physi cians. Epidemiologic data indicate that nasal allergy is common in patients with asthma, otitis media, sinusitis, and nasal polyps, and emerging evide nce suggests that allergic rhinitis is a risk factor for developing asthma. Laboratory studies have also demonstrated that induction of a nasal allerg ic response causes anatomic or physiologic alterations of the lower airways , eustachian tubes, and paranasal sinuses. Although clinical studies sugges t that treatment of rhinitis improves subjective and objective measures of asthma, it is less clear that nasal therapy has significant effects on otit is media, sinusitis, and nasal polyps. Allergic rhinitis should be consider ed as a concomitant diagnosis in patients with other airway diseases, parti cularly asthma, and should be treated aggressively when identified.