Ear Nose & Throat Sydney
Dr  Narinder Singh  MBBS (Syd) FRACS (ORL-HNS) - Consultant ENT Specialist Surgeon - Clinical Lecturer University of Sydney
Ear Nose & Throat Sydney, Dr Narinder Singh
Ear Nose & Throat Sydney, Dr Narinder Singh Ear Nose & Throat Sydney, Dr Narinder Singh
 
Ear Nose Throat

Allergic rhinitis (Allergy/ Hay fever)

What Is Allergic Rhinitis?

Allergic rhinitis is allergy that affects the nose.

Allergy is when a person is sensitive to something in the environment that most people are not sensitive to.

Other allergy diseases include atopic asthma (lungs) and eczema (skin).

The commonest allergy triggers include:

  • Pollen (grass, tree) - this triggers Hayfever
  • House dust mite
  • Cat, Dog
  • Cockroach
  • Moulds/ fungus

Allergy causes irritation of the lining of the nose and sinuses. This results in:

  • Congestion/ blocked nose
  • Sneezing
  • Itching
  • Watery nose

How can I find out if I have Allergic rhinitis?

Always see your GP first. Your GP will look inside your nose and may order some tests or prescribe some medications. If your GP cannot fix your allergic rhinitis, ask your GP for a referral to see Dr Singh.

What tests can my GP order?

Some tests that your GP may order include:

  • Skin prick tests
  • RAST blood tests: Blood tests are not as accurate as skin prick tests but are easier to perform.

What if my GP can't treat my Allergic Rhinitis?

Ask your GP for a referral to see Dr Singh.

What treatments can my GP prescribe?

Some treatments that your GP may prescribe include:

  • Allergen avoidance - Some triggers can be avoided.
  • Nasal saline rinse - This washes out the inside of the nose and sinuses
  • Nasal steroid sprays - These shrink the lining of the nose to allow more air through.
  • Antihistamine tablets/ sprays

What if the treatment from my GP doesn't work?

Ask your GP for a referral to see Dr Singh.

How can Dr Singh find out more about my Allergic Rhinitis?

Dr Singh is a nose and sinus specialist. Dr Singh uses special tests to thoroughly investigate your Allergic Rhinitis.

What tests can Dr Singh perform?

Dr Singh may order a CT scan, allergy tests and blood tests, and nasal function tests, which show the amount of airflow through your nose.

Our practice is unique as we have a CT scanner on-site and a trained scientist in-house. This means all of the following tests can be performed on-site, without the need for multiple appointments at multiple locations:

  • CT scan
  • Skin prick tests
  • Blood tests
  • Rhinomanometry and Acoustic Rhinometry (Nasal airflow tests)
  • Sleep study

Dr Singh will examine your nose using special instruments.

Dr Singh will also pass a special super-fine camera into your nose to look at the septum, turbinates and sinus openings (the nose is made numb first using a special numbing spray). You can watch the camera on a TV monitor and see for yourself exactly what is contributing to your problems.

Despite all the tests and high-technology available, the most accurate tool is your doctor's knowledge, training and experience!

Can my Allergic Rhinitis be treated?

Yes.

In almost every case of Allergic Rhinitis, the cause can be found and treated.

How is Allergic Rhinitis treated?

The treatment used will depend on Dr Singh's assessment. Options include:

  • Allergen avoidance: Some triggers, like cat and dog can be avoided. Mould and House Dust Mite can be reduced by making changes to the house and furniture.
  • Saline rinse: Try rinsing the nose 2-4 times a day with salty water from your pharmacy.
  • Medications:
    • Intra-nasal steroid sprays
    • Anti-histamine tablets/ sprays
  • Immunotherapy: A series of injections over several years can reduce sensitivity to allergic triggers. The injections are given weekly then monthly. These are given by an immunologist (Allergy specialist).
  • Sublingual Immunotherapy: These are sprays/drops placed under the tongue, which can reduce sensitivity to allergic triggers. These are given every day. Sublingual immunotherapy is easier to tolerate than injections. As it is self-administered, you won't need to see the doctor each time. It is very effective in children. Our practice is unique as our in-house Allergy scientist can arrange sublingual immunotherapy for you directly.
  • Surgery: Surgery to the septum and inferior turbinates can unblock the nose and improve breathing. Surgery cannot cure allergy and you may still experience itching, sneezing and runny nose. However, you will breathe much better through an unblocked nose. For most patients, the biggest complaint about allergy is the blocked nose.

Do I need to see an Immunologist (Allergy Specialist)?

Dr Singh is an expert is treating the anatomical blockages contributing to Allergic Rhinitis symptoms. Dr Singh can help you with treatment for simple Allergic Rhinitis. However, Dr Singh or your GP may refer you to see an Immunologist (Allergy specialist) in some of the following cases:

  • Severe/ poorly controlled Allergic Rhinitis
  • When Subcutaneous immunotherapy (injections) is required
  • Significant Asthma as well as Allergic Rhinitis
  • Allergic Rhinitis to multiple or unusual triggers
  • Unusual or complicated Allergic Rhinitis

I have already tried all the medications! Tell me more about surgery?

Surgery for Allergic Rhinitis will depend on Dr Singh's assessment.

Dr Singh may recommend one or more ofthe following procedures:

  • Large Inferior Turbinates: These are fixed with a Turbinoplasty operation
  • Deviated septum: This is fixed with a Septoplasty operation
  • Nasal polyps: These are fixed with a Polypectomy operation
  • External valve collapse (Collapse of the side walls of the nose): This is fixed with a Functional Rhinoplasty operation
  • Bent or twisted nose: This is fixed with a Rhinoplasty operation
  • Large Adenoids: These are fixed with an Adenoidectomy operation
  • Excessive post-nasal drip: This sometimes requires a Vidian Neurectomy operation

Are there any alternative treatments to surgery?

Yes. There are always options and it is always your choice as to whether to have surgery. In general, you can try other options first and choose surgery if nothing else works. Non-surgical options include:

  • Allergen avoidance - Some triggers can be avoided.
  • Nasal saline rinse - This washes out the inside of the nose and sinuses
  • Nasal steroid sprays - These shrink the lining of the nose to allow more air through.
  • Antihistamine tablets/ sprays
  • Immunotherapy

We recommend that you see your GP first and consider trying these non-surgical options. Then see Dr Singh when you are ready for surgery. There is a long waiting list to see Dr Singh and it is best if you see Dr Singh for surgery after the non-surgical treatments have failed.

Are there any risks to surgery?

Yes. Everything we do in life has risks. Even something as simple as crossing the street has risks…but we still cross the street. Dr Singh will explain the risks of your operation and provide you with an information pamphlet that explains the risks in detail. If you have any questions about risks, ask Dr Singh during your consultation.

What should I do next?

See your GP. If your GP is unable to treat your Allergic Rhinitis, ask your GP for a referral to see Dr Singh.

I have already seen a doctor - I was told nothing could be done for my Allergic Rhinitis. What should I do?

Most cases of Allergic Rhinitis can be fixed or improved. Dr Singh is a nose and sinus specialist and has expertise in difficult and complex cases.

Consider asking your GP for a referral to see Dr Singh.

 

I have already seen a surgeon and had an operation on my nose. It didn't work! What should I do?

Most cases of Allergic Rhinitis can be treated or improved. Dr Singh is a nose and sinus specialist and has expertise in performing revision surgery.

We recommend that you return to see your original surgeon first. If nothing further can be done and you still have symptoms, consider asking your original surgeon or your GP for a referral to see Dr Singh. Dr Singh always works together with your GP and your other specialists to achieve your best health outcome.

DISCLAIMER: The material on this page represents general information only and is NOT medical advice. For specific medical advice about your individual circumstances you must consult a trained medical practitioner. Always see your GP first. If your GP is unable to fix your nose or sinus problem, ask your GP for a referral to Dr Singh. Dr Singh always works together with you and your GP to achieve your best health outcome. IMPORTANT: Do not try to diagnose your medical problem by yourself! Do not rely solely on information found on the internet. Always see your GP first.

Copyright Notice: The material on this page is protected by International Copyright Legislation and remains the intellectual property of ENT Sydney, Dr Narinder Singh. Do not copy any part of this page or this website, on the internet, in print or in any other form. Unlicensed copies of this information are automatically detected by our Internet hosting service. Offenders will be prosecuted.

This material may be reproduced, with written permission, under license from the copyright holder. A licensing fee applies. For further information, please contact us. Charitable or non-profit organisations wishing to reproduce this information should contact us.

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