Rhinology and Allergology for Chronic and Acute Diseases of the Nose and Sinuses

Rhinology, or the study of the nose, deals with diseases and injuries

• of the nose,
• the paranasal sinuses, and
• the anterior skull base.

Rhinology is considered a branch of otolaryngology (ENT). Any symptoms in this area, such as

• mucus in the throat,
• difficulty breathing through the nose,
• nasal obstruction (difficulty breathing through the nose), and
• nosebleeds

are therefore cases for an ENT specialist.

The spectrum of diseases affecting the nose and paranasal sinuses is wide-ranging. Given the steadily rising number of people affected across all age groups, allergies are the primary concern here.

Experts attribute this trend, among other things, to the high concentration of harmful environmental factors. Risk factors include, for example,

• an immune system weakened by excessive hygiene measures during childhood,
• excessive stress, and
• an overall unhealthy lifestyle.

Rhinology deals with the diagnosis and treatment of problems with the nose and its function © bilderzwerg | AdobeStock

A specialist in rhinology treats the following symptoms and conditions, among others:

• allergic rhinitis (hay fever) and non-allergic rhinitis.
• Nasal polyps, sinus infections, and chronic rhinosinusitis (simultaneous inflammation of the nasal mucosa and sinuses),
• fungal forms of sinusitis, particularly allergic fungal rhinosinusitis,
• mucoceles primarily in the paranasal sinuses (accumulation of mucus), caused by impaired drainage of secretions,
• benign tumors such as inverted papillomas (tumors of the mucous membrane of the nasal cavity and paranasal sinuses), angiofibromas (tumors in the nasopharyngeal region), osteomas (bone tumors),
• malignant tumors in the nose, paranasal sinuses, and anterior skull base,
• dysosmia (disorders of the sense of smell),
• skull base defects with cerebrospinal fluid leaking from the cerebrospinal fluid spaces (CSF leak).

The first step in determining the nature of your symptoms is taking your medical history. During this process, your ENT doctor will ask questions about

• symptoms,
• medical history, and
• similar symptoms in your family.

This discussion allows your doctor to make an initial assessment of the specific clinical picture. Further examinations are then conducted based on this assessment.

Rhinomanometry, for example, is a key component of rhinological diagnostics. It is used to measure nasal airflow. The results determine the steps to be taken to alleviate nasal breathing difficulties.

Depending on your symptoms, your doctor will use various diagnostic methods. In the case of smell disorders, for example, smell tests are appropriate. If a tumor is suspected, ultrasound devices as well as rigid and flexible endoscopes with high light intensity are used.

Endoscopy is also essential for a reliable diagnosis. Three subcategories are worth mentioning here:

1. video endoscopy: The recording and storage of findings on video,
2. flexible fiber endoscopy: Provides a view of hard-to-reach areas, such as the nasopharynx, and
3. nasal endoscopy: Enables visualization of the interior of the nose, including the sinus ostia.

Many conditions in the field of rhinology can be treated with medication, such as allergies.

There have been major advances in surgical procedures in recent years. Consequently, large incisions in the head or face are no longer necessary for effective surgical procedures.

Instead, minimally invasive, computer-assisted surgical techniques are now used. In the majority of cases, the procedure is performed through the nostrils, eliminating the need for a skin incision.

Patients benefit from these new methods in nasal surgery in several ways:

• The healing process is accelerated,
• discomfort ideally subsides completely, and
• there is no risk of unsightly scars that are clearly visible to others.

ENT doctors are the first and best point of contact for nasal complaints. However, your primary care physician can also provide initial care and guidance.

Depending on their additional qualifications, you may already find the right specialist for your condition this way. For example, many general practitioners’ offices can test you for a pollen allergy. If in doubt, however, your general practitioner will refer you to a specialist in allergology.

Depending on your symptoms, the involvement of an interdisciplinary team may also be necessary. In cases of injury or a tumor in the skull region, neurosurgeons may also be consulted.

Rhinology isn’t limited to health issues affecting the nose and sinuses. Rhinologists also address aesthetic concerns.

A surgical procedure, such as a nose job, can often address two concerns at once. For example, surgical treatment of a deviated septum can resolve smell disorders. Depending on the patient’s wishes, a rhinoplasty surgeon can correct the deviation at the same time.

What is Rhinology?

Rhinology is a subspecialty of otolaryngology that focuses on diseases of the nose and paranasal sinuses. This includes both acute and chronic conditions that can impair nasal breathing, the nasal mucosa, and quality of life. Treatment is provided by an experienced ENT physician or at a specialized ENT clinic.

What conditions are treated in rhinology?

The most common conditions affecting the nose include rhinosinusitis, sinus infections, nasal polyps, nosebleeds, and allergic symptoms. Chronic sinusitis, polyposis, and anatomically related problems of the nasal septum are also treated in rhinology. In addition, conditions affecting the external nose and the turbinates fall within this specialty.

When is surgery necessary?

If conservative or medical treatments do not result in sufficient improvement, surgical or endoscopic procedures may be appropriate. Common procedures include nasal septum correction, sinus surgery, or other surgical interventions to improve nasal breathing. Modern surgical techniques are generally minimally invasive and result in minimal scarring.

What role does allergology play in rhinology?

Allergology is closely linked to rhinology, as many nasal disorders are triggered by allergies or allergic reactions. Typical symptoms include a runny nose, swelling of the mucous membranes, and impaired nasal breathing. Targeted diagnostics help develop effective treatment strategies that address the underlying cause.

What symptoms may indicate a sinus disorder?

Typical symptoms include headache, facial pain, a stuffy nose, impaired nasal breathing, and recurrent inflammation. The mucous membranes, throat, and inhaled air may also be affected. For chronic symptoms, modern treatment options such as biologics, endoscopic procedures, or conservative and surgical treatments may also be considered.