Paediatric Rhinitis and Rhinosinusitis

Rhinitis may be defined as an inflammatory condition affecting the upper airways in which rhinorrhoea, nasal congestion or sneezing (or any combination thereof) has been present a minimum of 2 days in a row and lasts for at least 1 h on the majority of those days. The Allergic Rhinitis and Its Impact on Asthma (ARIA) guideline distinguishes two categories of rhinitis: allergic rhinitis (AR) and non-allergic rhinitis (NAR). The differentiating feature between these conditions is whether allergic sensitisation has taken place (i.e. AR) or not (NAR). The pathophysiology of AR depends on IgE, and it is usual for ocular pruritus, indicating conjunctivitis, to be present as an additional presenting feature. Rhinitis frequently occurs in children and adolescents. It is commonplace to dismiss the significant morbidity associated with the condition by viewing rhinitis as a self-limited coryzal illness. However, sternutation, pruritus, watery nasal discharge and nasal congestion are distressing for patients. The presentation in childhood and adolescence may also be atypical, with coughing or snoring. Rhinitis has an adverse effect on biopsychosocial well-being. In this chapter, paediatric rhinitis and rhinosinusitis are reviewed in all aspects.