Differentiating Rhinitis in the Paediatric Population by Giving Focus on Medical History and Clinical Examination

Doulaptsi, Maria; Aoi, Noriaki; Kawauchi, Hideyuki; Milioni, Athanasia; Karatzanis, Alexander; Prokopakis, Emmanuel

Detailed information regarding the prevalence and burden of NAR in children is lacking. This category includes children with chronic rhinitis whose symptoms cannot be attributed to AR and infectious rhinitis. The diagnosis of NAR is again based on a detailed medical history [3] . Symptoms may be continuously present or induced by exposure to special triggers, such as systematically or intranasal taken medications, gastroesophageal reflux, and hormones. Temperature and humidity changes, physical exercise, tobacco smoke, and perfumes are known for inducing an overall hyper responsiveness of nasal mucosa [31] . In a significant portion of patients, no clear aetiology can be identified (idiopathic rhinitis). Idiopathic rhinitis is considered a diagnosis of exclusion. NAR prevalence remains steady across different age groups in paediatric population [10] . Besides history and anterior rhinoscopy, nasal endoscopy is essential in this type of rhinitis where features are unclear. Nasal endoscopy allows us to inspect the whole nasal cavity and exclude presence of nasal polyps or other pathologies like infection, significant anatomic deformities, and nasal tumours.