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What is Rhinitis?

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Florida Gulf Coast Ear, Nose & Throat

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Aug 08, 2023

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Rhinitis is an incredibly common condition, affecting more than 20 million adults and more than 7 million children in the United States each year. Rhinitis means inflammation of the nose and is characterized by symptoms resulting from inflammation of the nasal mucous membrane. Rhinitis is frequently confused with sinusitis (inflammation of the sinus spaces), and most people who think they have sinusitis are really suffering from chronic rhinitis.

Symptoms- Nasal congestion Difficult breathing Sneezing Runny nose Post-nasal drainage Itchy nose Headaches

Rhinitis features inflammation and swelling of the mucous membranes, a moist tissue that lines the nasal cavity. The purpose of this membrane is to trap dust, pollen, bacteria, viruses and other particles in a thin fluid called mucus. Tiny hairs called cilia move the particles down the throat. This keeps the air that goes into your lungs clean and free of debris. When this membrane becomes irritated, it can cause reactions such as thickened mucus, swelling, stuffy nose, difficulty breathing, sneezing and headaches. While rhinitis usually isn’t serious, its symptoms can negatively impact sleeping, exercising, and other daily activities. Rhinitis can be acute or chronic. Acute rhinitis is temporary, lasting a few days in most people. In others, chronic rhinitis can last weeks or months, and often recurs.

ALLERGIC RHINITIS

Most commonly, rhinitis is caused by an allergen. An allergen is a substance that a person’s immune system recognizes as foreign or dangerous. As a result, the immune system reacts by making a type of antibody (a protein intended to neutralize the foreign substance) called Immunoglobulin E (IgE) to defend against the allergen. This reaction leads to the release of inflammatory chemicals such as histamine. When an allergen is the cause, it is called allergic rhinitis. Allergic rhinitis can be seasonal or perennial. Seasonal allergic rhinitis is caused by an allergen that appears at a certain time of the year, such as tree pollen in the spring, grass pollen in the summer, and weed pollen and mold spores in the fall. Perennial allergic rhinitis can exist year-round from exposure to certain foods and medicines, pets and other animals, and dust mites in carpeting and upholstery. Southwest Florida is in a tropical climate zone. While allergens here do have seasonal variation, the growing season is 12 months long, making perennial symptoms much more common than in more northern climate zones. Common Allergens- Pollen, Drugs and medicines, Dust, Mites, Certian Beverages, Mold or fungal spores, insect venom animal proteins and dander and Chemicals.

When you visit Florida Gulf Coast ENT with suspected rhinitis, your physician will ask you about your symptoms, including when they began, the severity, frequency, known triggers, and progression. Your physician will want to know what treatments you’ve tried and if they’ve been successful, and will ask about your medical history and any prior allergy testing, lab testing or imaging. Your physician will examine the inside of your nose to evaluate the color of your nasal membrane, the amount, color and consistency of mucus, and look for swelling and any abnormalities that could be causing or contributing to your symptoms, such as a deviated septum or nasal polyps. Your physician may perform a nasal endoscopy, which uses a small camera and light to visualize the sinus openings and the back of the nose all the way to the nasopharynx and throat. Depending on what is seen in the physical exam, additional tests may be performed, such as allergy tests, pulmonary function tests, lab testing, x-rays or CAT scans. Florida Gulf Coast ENT can perform a number of these diagnostic tests in the office for your convenience. Once a diagnosis of rhinitis is made, your physician will develop a personalized treatment plan to help you reduce or eliminate known causes and triggers and control your symptoms with avoidance measures, environmental control, medications, immunotherapy or surgery. Treatment of allergic rhinitis is based on the type and severity of symptoms, in addition to a person’s age, other medical conditions, daily medications, and overall health. A personalized treatment plan is required to manage allergy problems, as each individual experiences their allergy symptoms differently. Your physician at Florida Gulf Coast ENT can help you determine appropriate treatment.

Initial Treatments for Allergic Rhinitis

Allergy testing with counseling and avoidance of the substances that trigger the allergies. Nasal irrigation flushes saline (a saltwater solution) through your nasal cavity to remove allergens and excess mucus, and to moisten the mucous membranes. This can be done with a squeeze bottle or with a number of different irrigation devices found at your local pharmacy. Antihistamines reduce or block histamine, the major inflammatory chemical your body produces in reaction to an allergen. These medications can help with itchiness, runny nose, and sneezing, but are less effective at easing congestion. Antihistamines are available as tablets, capsules, liquids, nasal sprays, and eyedrops. They are available in both prescription and over-the-counter (OTC) formulas. Nasal corticosteroid sprays reduce nasal inflammation and swelling and excess mucus, making it easier to breathe. They also ease congestion, runny nose, sneezing, and itching. They are available in both prescription and over-the-counter (OTC) formulas. Decongestants reduce congestion by shrinking swollen blood vessels and nasal tissue. They don’t ease sneezing or itching symptoms. Decongestants are available as tablets, liquids, nasal drops, and nasal sprays. They are available in prescription and over-the-counter (OTC) formulas. Some are available without a prescription but must be obtained from behind the pharmacy counter. Decongestants can have adverse effects on blood pressure and heart function. They should be used with caution or under doctor supervision. Initial Treatments for Allergic Rhinitis Medications don't improve symptoms in Medications don't improve symptoms in every individual. Some people require every individual. Some people require daily medications or multiple daily medications or multiple medications to control their symptoms. medications to control their symptoms. In these cases, it's better to control the In these cases, it's better to control the symptoms by stopping the allergic symptoms by stopping the allergic reaction from occurring. There are reaction from occurring. There are therapies that will change the immune therapies that will change the immune system and make a person less allergic .system and make a person less allergic. Allergy immunotherapy Allergy immunotherapy uses injections uses injections or sublingual (under the tongue) drops to or sublingual (under the tongue) drops to expose a person to small, increasing expose a person to small, increasing doses of a known allergen. Over time, this doses of a known allergen. Over time, this reduces the IgE antibodies while building reduces the IgE antibodies while building “blocking antibodies” that eliminate“ blocking antibodies” that eliminate allergens from the body, helping to allergens from the body, helping to develop tolerance to the allergen. This develop tolerance to the allergen. This makes the person less allergic and makes the person less allergic and reduces or eliminates symptoms .reduces or eliminates symptoms. Overuse of decongestant nasal drops or Overuse of decongestant nasal drops or sprays can cause even more severe nasal sprays can cause even more severe nasal congestion when the decongestant congestion when the decongestant wears off, called rebound congestion. wears off, called rebound congestion. Talk to your physician at Florida Gulf Talk to your physician at Florida Gulf Coast ENT about proper usage of Coast ENT about proper usage of decongestants .decongestants .Allergy immunotherapy is the best long-term alternative for chronic allergic rhinitis symptoms. There are no procedures that will cure allergies, but some can reduce specific allergic rhinitis symptoms, including improved breathing and decreased sense of congestion. The procedures may reduce sense of ear fullness and pressure, facial pressure, and may reduce nasal drainage. The options include both surgical and less invasive in-office procedures. ALLERGIC RHINITIS- Overuse of decongestant nasal drops or sprays can cause even more severe nasal sprays can cause even more severe nasal congestion when the decongestant congestion when the decongestant wears off, called rebound congestion .wears off, called rebound congestion. Talk to your physician at Florida Gulf Talk to your physician at Florida Gulf Coast ENT about proper usage of Coast ENT about proper usage of decongestants.

Allergy immunotherapy is the best long-term alternative for chronic allergic rhinitis symptoms. There are no procedures that will cure allergies, but some can reduce specific allergic rhinitis symptoms, including improved breathing and decreased sense of congestion. The procedures may reduce sense of ear fullness and pressure, facial pressure, and may reduce nasal drainage. The options include both surgical and less invasive in-office procedures. ALLERGIC RHINITIS Common Allergens Procedural Options for Allergic Rhinitis Inferior Turbinoplasty Nasal obstruction is commonly caused by enlargement of structures in the nose called the turbinates. Most people have never heard of the turbinates, but almost everybody has complained about their turbinates numerous times in their life. These structures are full of glandular tissue that can expand like a grape or shrink like a raisin. A very successful and minimally invasive procedure, called a turbinoplasty, removes the glandular tissue from the turbinate, reducing its size, prohibiting further growth, and reducing obstruction in the nasal cavity. The procedure is over 90% successful at improving breathing and nasal congestion, is well-tolerated and performed easily in the office, and has few restrictions or risks following the procedure. Intranasal Ablations Intranasal ablation procedures work on specific areas of swelling in the nasal cavity to improve the openness of the nasal cavities and sinuses. Ablations decrease the glandular tissue that causes nasal obstruction, congestion, and drainage. Ablations to some of the nasal nerves can decrease the stimulation of the glands to produce mucus, reducing nasal drainage. This works especially well in individuals who frequently feel thin watery drainage running out of their nose, a condition frequently worsened by eating. Some of the most common ablation procedures are known as the Rhinaer and Clarifix procedures. The physicians at Florida Gulf Coast ENT have access to multiple ablation devices that can treat each individual’s needs. Balloon Sinuplasty While typically performed specifically for chronic sinusitis, balloon sinuplasty can benefit patients with chronic rhinitis who are prone to more frequent nasal infections. Balloon sinuplasty opens the sinus drainage tracts to allow for better drainage and equalization of pressure. It can be performed safely and easily in the office with minimal post-procedure restrictions or risks. Rhinoplasty Typically a cosmetic procedure, some external and cosmetic nasal defects can significantly affect nasal breathing. Florida Gulf Coast ENT has physicians who specialize in rhinoplasty for both functional and cosmetic reasons.

Septoplasty The nasal septum (the cartilage and bone in the middle of the nose that should divide the nose into two equal halves) is one of the most common reasons for chronic nasal obstruction. As we age, and in response to specific nasal or facial trauma, this cartilage and bone begins to shift away from the center, narrowing the breathing passages. Septoplasty surgery can provide significant improvement in nasal breathing and reduce the number of sinus infections in certain individuals. It is typically performed at a surgery center or hospital under general anesthesia. However, some deviations can be improved with in-office procedures. In-office balloon assisted septoplasty is becoming a more common procedure. It's currently not covered by insurance, but is a less invasive option that can be performed in the office to improve nasal breathing. Chronic inflammation of the nasal mucous membrane can nasal mucous membrane can cause nasal polyps, sinusitis, or cause nasal polyps, sinusitis, or middle ear infections. Talk to middle ear infections. Talk to your physician about your physician about controlling your symptoms to controlling your symptoms to help prevent these help prevent these complications.

NON-ALLERGIC RHINITIS

Non-allergic rhinitis is caused by something other than an allergic reaction. A diagnosis of non-allergic rhinitis is made after an allergic cause is ruled out. Even if you do have allergies, non-allergic rhinitis can develop from other causes, including: Nasal blockages Bacterial infections and viruses Certain medications Certain foods and beverages, including alcohol Odors or irritants in the air Weather or temperature changes Aging Hormonal changes or pregnancy Inflammation or irritation in the nose unrelated to allergy Other health conditions Treatment of Non-Allergic Rhinitis Your physician at Florida Gulf Coast ENT can help rule out allergic rhinitis and help determine the cause for non-allergic rhinitis. If a cause can be determined, that trigger should be avoided as much as possible, or treated appropriately if it's another medical condition such as an infection. Often, the cause of non-allergic rhinitis can’t be determined, but your physician can help you control the symptoms. While there are fewer medication options for treating non-allergic rhinitis, there are some office procedures that may help to alleviate the symptoms. The physicians at Florida Gulf Coast ENT have access to all available technologies that might improve breathing and drainage in those who suffer from non-allergic rhinitis. Non-allergic rhinitis doesn't typically cause itchy nose, eyes or throat. Non-allergic rhinitis doesn't typically cause itchy nose, eyes or throat. If non-allergic rhinitis is caused by a viral or bacterial infection, If non-allergic rhinitis is caused by a viral or bacterial infection, fever may be present. fever may be present. Asthma Sinusitis Conjunctivitis Dermatitis Eustachian tube dysfunction Nasal polyps Sleep disturbance

RELATED CONDITIONS

There are many other conditions that feature symptoms similar to those of rhinitis. These conditions may or may not exist concurrently with rhinitis. It’s important to talk to your physician at Florida Gulf Coast ENT about your symptoms to determine the particular condition and treatment. Asthma Sinusitis Conjunctivitis Dermatitis Eustachian tube dysfunction Nasal polyps Sleep disturbance.

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Hill, III, MD, FACS, FAAOABOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Board of Otolaryngology, Head and Neck SurgeryState of FloridaEDUCATIONUniversity of Michigan Bachelor of Science Magna Cum LaudePOSTGRADUATE TRAININGWayne State University Detroit Medical Center Doctor of MedicineWayne State University Detroit Medical Center Internship General SurgeryWayne State University Detroit Medical Center Residency Otololaryngology/Head & Neck SurgeryEar Research Foundation at The Silverstein Institute Fellowship Neuro-otology/Advanced Otologic and Skull Base SurgeryPROFESSIONAL MEMBERSHIPSAmerican Academy of Otolaryngology, Head and Neck SurgeryAmerican College of SurgeonsAmerican Academy of Otolayngic AllergyFlorida Medical AssociationCollier County Medical SocietyLee County Medical SocietyWayne State University Medical Alumni SocietyUniversity of Michigan Alumni SocietyPatrick M. Reidy, MDBOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Board of Otolaryngology, Head and Neck SurgeryState of FloridaEDUCATIONUniversity of Michigan Bachelor of Science GO BLUE!!POSTGRADUATE TRAININGWayne State University Detroit Medical Center Doctor of MedicineWayne State University Detroit Medical Center Internship General SurgeryWayne State University Detroit Medical Center Residency Otololaryngology/Head and Neck SurgeryUniversity of Chicago Medical Center Fellowship Rhinology / Allergy / Advanced Sinus SurgeryPROFESSIONAL MEMBERSHIPSAlpha Omega Alpha Medical Honor SocietyAmerican Academy of Otolaryngology, Head and Neck SurgeryAmerican Rhinological SocietyFlorida Medical AssociationCollier County Medical SocietyLee County Medical SocietyUniversity of Michigan Alumni SocietyWayne State University Medical Alumni SocietyLeela Lavasani, MD, FACSDr. Lavasani offers a comprehensive program of specialized ear, nose and throat care that reflects our commitment to delivering individualized and optimal treatment to patients of all ages. She has the experience and skill to provide comprehensive diagnosis and management of diseases that affect the ears, nose and paranasal sinuses, voice, throat, thyroid and neck.BOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Board of Otolaryngology, Head and Neck SurgeryState of FloridaEDUCATIONMacalester College Bachelor of Arts BiologyPOSTGRADUATE TRAININGChicago Medical School- Masters of Science- Applied PhysiologyGeorge Washington University School of Medicine Doctor of MedicineThomas Jefferson University Residency OtolaryngologyPROFESSIONAL MEMBERSHIPSAmerican Academy of Otolaryngology, Head and Neck SurgeryAmerican College of SurgeonsAmerican Medical Womens AssociationAlpha Omega Alpha of OtolaryngologyCollier County Medical SocietyBenjamin Lehmkuhl, DOFlorida Gulf Coast ENT is happy to welcome our newest physician to the team, Dr. Ben Lehmkuhl. 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BOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Board of Otolaryngology, Head and Neck Surgery EligibleState of FloridaEDUCATIONClarke University, Debuque, IA Bachelor of Science in BiologyPOST GRADUATE TRAININGDes Moines University, College of Osteopathic Medicine, Des Moines, IA -Doctor of Osteopathic MedicineWestern Reserve Hospital, Cuyahoga Falls, OH Otolaryngology Head and Neck Surgery ResidencyUniversity of Kentucky, Lexington, KY Otolaryngology Head and Neck Surgery ResidencyPROFESSIONAL MEMBERSHIPS:American Academy of Otolaryngology Head and Neck SurgeryKentucky Society of OtolaryngologyAmerican Osteopathic Association MemberLee County Medical Society MemberChristie McGee, MDA native of South Florida, Dr. McGee completed Otolaryngology residency training in Miami, FL, and is excited to utilize her comprehensive skills and training to treat the community of Collier County. Dr. McGee offers comprehensive surgical and medical Otolaryngologic care to patients of all ages for the following conditions:Diseases of the Paranasal Sinuses and Nasal Cavity including allergic rhinitis, chronic rhinosinusitis, sinonasal polyp disease, complex sinus infections, deviated septum, nasal obstruction, nosebleeds, and smell lossAcute and chronic hearing loss, ear infections, perforated eardrum, eustachian tube dysfunction, vertigoPediatric sleep-disordered breathing, tonsillectomy, adenoidectomy, ear tubes, congenital lesions, speech and swallow disordersDiseases of the airway and larynx including voice and swallow changes, vocal cord paralysis, benign lesions, and malignancies, as well as tracheostomy and cervical airway scar tissue managementBenign and malignant lesions of the upper aerodigestive tract, thyroid gland, neck, salivary glands, and skin of the head and neckFacial paralysisAge-related changes of the face including management of wrinkles with BotoxAdult surgical management of obstructive sleep apnea and snoringBOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Board of Otolaryngology- Head and Neck Surgery EligibleState of FloridaEDUCATIONUniversity of Florida- Bachelor of Science in Biology- Magna Cum LaudePOSTGRADUATE TRAININGTufts University School of Medicine- Masters of Science in Biomedical SciencesUniversity of Miami Miller School of Medicine- Doctor of MedicineUniversity of Miami/Jackson Memorial Hospital- Residency- Otolaryngology and Head and Neck SurgeryPROFESSIONAL MEMBERSHIPSAmerican Academy of Otolaryngology- Head and Neck SurgeryAmerican Rhinologic SocietyFlorida Society of Otolaryngology- Head and Neck SurgeryGold Humanism Honor SocietyCollier County Medical SocietyNicole Gergenti, FNP-BCNicole Gergenti is a board certified Family Nurse Practitioner. She was born in New York but raised in Southwest Florida. She has always had a passion for serving others, which is what drove her ambition to pursue a career in the medical field. After obtaining her first bachelors degree in human performance from Florida Gulf Coast University, she quickly knew the career path she wanted to pursue. She then acquired her second bachelors degree in nursing from Nova Southeastern University. She began her nursing career as a registered nurse for Lee Health on their surgical oncology unit. During her time working at the hospital, she continued her education at Nova Southeastern University and obtained her masters in nursing as a Family Nurse Practitioner. She strives to always listen to and provide her patients with the utmost best care possible.EDUCATIONFlorida Gulf Coast University- Bachelor of Science in Human PerformanceNova Southeastern University- Bachelor of Science in NursingNova Southeastern University- Masters in NursingSuelay Plasencia, DNP, APRN, NP-CSuelay Plasencia is a board-certified doctorate prepared Family Nurse Practitioner. She is born and raised in Florida and has extensive nursing experience in critical care and oncology. She started her career as a nurse at Moffitt Cancer Center and continued her oncology career at Lee Memorial Hospital. She has transitioned her education into a nurse practitioner with training at Moffitt Cancer Center and several outpatient family practices. Sue is passionate about providing affordable and convenient care for all patients. She has the dedication and skill to provide detailed care for diseases affecting the ear, nose, paranasal sinuses, throat, thyroid, and neck.BOARD CERTIFICATION AND MEDICAL LICENSUREAmerican Academy of Nurse Practitioners- Family Nurse PractitionerState of FloridaEDUCATIONSouth University Tampa- Bachelor of Science in NursingPalm Beach Atlantic University- Doctorate in Nursing PracticePROFESSIONAL MEMBERSHIPSSigma Theta Tau Honor SocietyAmerican Academy of Nurse PractitionersOncology Nursing SocietyNurse Practitioner Council of Collier CountyNurse Practitioner Council of Lee CountyChristopher Hatwell, PA-C, MMSBorn and raised in New Jersey, Christopher has called Southwest Florida home for 25 years. He completed his physician assistant training at Nova Southeastern while serving as class president and graduating with honors. He has practiced locally since graduation with experience in family practice as well as neurology. He has a passion for treating illness, patient education and expanding his medical knowledge to help better treat his patients. When not in the office he can be found with his wife and two sons playing sports and enjoying the beaches and waterways of Naples.Audiology TeamSHANAI HILL, AU.D., CCC-ADr. Shanai Hill has been with Florida Gulf Coast ENT and Hearing Center since its inception in 2005. She helped to create the Audiology Department alongside her husband, Dr. Samuel Hill and his partner, Dr. Patrick Reidy. She currently provides hearing and hearing aid services including hearing aid evaluation, demonstrations, repairs, and sales at our Estero location. Dr. Hill believes that the hearing rehabilitation process should be much more than a retail transaction. She is dedicated to working closely with her patients as they embark on their journey to better hearing. She provides continuous education, counseling, validation and technological support for her patients and their families in order to improve their communication abilities and their overall quality of life.Prior to her time with FCGHC, she practiced Pediatric Audiology at All Childrens Specialty Care Center/Johns Hopkins in Ft. Myers and the Childrens Hospital of Michigan. During that time, she diagnosed and treated pediatric hearing loss including participating in the Craniofacial/Cleft Palate Team and the Cochlear Implant Team. She also spent 2 years in the Michigan Public Schools System as an Educational Audiologist providing hearing therapy and hearing aid/ FM unit support for hearing impaired students.Dr. Hill has a Bachelor of Arts degree in Communication Disorders from Michigan State University, a Master of Science degree in Audiology from Wayne State University, and a Doctor of Audiology degree from the University of Florida. In her spare time, she enjoys traveling, cooking, having fun with her husband and teenage boys, and serving at her church.NICOLE DIEHL, AU.D., CCC-A, FAAADr. Diehl began her higher education by receiving a Bachelor of Science in Communication Sciences and Disorders from Ohio University in 2011. She later when on to obtain a Doctorate of Audiology at East Tennessee State University. During this time, she was trained at the Mountain Home Veterans Affairs Medical Center in evaluations of hearing, balance, tinnitus, and fitting of hearing aids and other assistive devices.Following her graduation from East Tennessee State University, she worked in private practice as well as at an ear, nose, and throat specialist. She worked in Dalton, Massachusetts as a diagnostic and dispensing audiologist at a private practice ENT for both adult and pediatric populations before relocating to Florida. Dr. Diehl is committed to improving her patients quality of life using state-of-the-art hearing technology.ELVERA BADER AU.DDr. Elvera Bader joined Florida Gulf Coast ENT in 2023 after moving to Florida with her husband and two daughters. Originally from New York, Dr. Bader earned her bachelors degree in communication sciences and disorders from CUNY Brooklyn College and her doctorate in Audiology from the CUNY Graduate Center in NYC.Before joining Florida Gulf Coast ENT, Dr. Bader worked independently at a small boutique practice in NYC, specializing in the hearing healthcare needs of musicians and others in the music industry. She later joined a busy Otolaryngology practice affiliated with the Northwell Health System, where she spent five years. During this time, she was part of a comprehensive team of providers focusing on the diagnosis and treatment/management of hearing disorders from birth through adulthood.Dr. Bader is dedicated to providing evidence-based care in a personalized, patient-centered approach, guiding her patients on their journey to improved hearing.

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