Causes
Rhinitis is a condition that encompasses more than a runny nose based upon the age of those affected and other contributing factors. Millions of Americans of all ages suffer from rhinitis each year due to upper respiratory infections, the common cold, inhalant allergies, sinus infections, chemical or airborne pollutants, or seasonal weather changes.

Incidence
A recent ENT Journal (Laryngoscope. 2012;July) article revealed the changing landscape and increased incidence of older rhinitis patients seen by ENT specialists. The Administration on Aging predicts that by 2030 there will be more than 72 million Americans over the age of 65. It is anticipated that over 30% of ENT patients will come from this geriatric age group. Five of the most common geriatric diagnoses: hearing loss and tinnitis; vertiginous and balance episodes; disorders of the inner ear and otitis media; throat related problems - dysphonia, hoarseness, and swallowing disorders; and head and neck cancer are frequently seen in this age population.

Physical Changes
The older patient is often frustrated by the constant reference by their doctor to their advanced age as a "catch-all" explanation for their diminished quality of life. Fourteen percent of patients over 65% suffer from sinusitis. Aging causes physical and physiological changes in the nose. The nose lengthens and the nasal tip droops which reduces the volume of air flow thru the nasal passages which causes a sense of nasal obstruction when lying down. Thick mucus production and nasal crusting within the nose, especially in the winter months, creates "sinus drainage" and a need to "hawk up" thick mucus when awakening. Decreased or distorted sense of smell and taste; "sinus trouble" with associated facial pressure, bad breath, and chronic headache; and hoarseness or dry throat from chronic throat clearing are all products of the nasal changes common with the aging process.

Treatment
Medications commonly taken by geriatric patients for other health conditions such as hypertension, osteoporosis, diabetes, and certain non prescription cold and allergy medicines often aggravate geriatric rhinitis. This can lead to active sinusitis leading to debilitating chronic severe sinusitis, bronchitis, and chronic cough that worsens asthma and chronic obstructive pulmonary disease. Inhalant allergies and longstanding nasal obstruction associated with chronic rhinitis in seniors can require aggressive allergy treatment or reconstructive nasal and endoscopic sinus surgery. Geriatric chronic sinusitis often requires a CT scan to diagnose it from chronic rhinitis. Newer in - office sinus procedures are now available that allow opening the sinus ducts within the nose, while awake and under local or topical anesthesia. This is especially useful for older patients who often do not desire, or because of other health conditions, are unable to tolerate general anesthesia in the operating room.

If you are a geriatric patient with suspected chronic rhinitis or sinusitis not responsive to medications contact our office for an appointment with Dr Sciacca for a thorough diagnostic evaluation.

For more information on Geriatric Rhinitis and Sinusitis

4501 Southlake Pkwy
Suite #200
Hoover, AL 35244