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

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