Turkish Guidelines for Diagnosis and Treatment of Allergic Rhinitis (ART)

OpenAlex İngilizce

Object: To prepare a national guideline for Otorhinolaryngologist who treat allergic rhinitis patients Methods: The study was conducted by three authors, namely the writing support team.The support team made the study plan, determined the writing instructions, chose the subgroups including the advisory committee, the advisors for authors and the authors.A workshop was organized at the very beginning to explain the details of the study to the team.Advisors took the chance to meet their coworkers in their subgroups and determined the main headings and subheadings of the guideline, together with the authors.After key words were determined by the authors, literature search was done in various databases.The authors keep in touch with the advisors and the advisors with the advisory committee and the support group at every stage of the study.National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline.Only Guideline and meta-analyses published in last seven years (2013)(2014)(2015)(2016)(2017) and randomized controlled studies published in last two years (2015-2017) were included.After all work was completed by the subgroups, support team brought all work together and edited the article. Results:A detailed guideline about all aspects of allergic rhinitis was created.Conclusion: The authors believe that this guideline will enable a compact and up-to-date information on allergic rhinitis to healthcare professionals.This guideline is the first in the field of Otolaryngology in Turkey.It should be updated at regular intervals. Key words: Allergic rhinitis, guideline, rhinitis Why have we composed this guide?Allergic rhinitis (AR) is a frequently seen global upper airway disorder affecting individuals at all ages.The upper airway is in continuum with a number of important regions, and disorders of upper airway cause significant comorbidities.The most frequent comorbidity of AR is asthma.Acute or chronic rhinosinusitis, otitis media with effusion, adenoid hypertrophy and gastroesophageal reflux may accompany AR.AR affects quality of life negatively since it is a frequent disease affecting individuals at all age groups, and may lead to complications.Although quantitative data collection by visualization through VAS helps the clinicians for the analysis of the symptom scores, this inventory is not sufficient to determine the comorbidities of the disease and to convert them into data.In this context, quality of life scales provide a standardized and numerical summary of the symptoms of the patient, and functional and psychosocial results of the disease and its treatment, and epidemiological analysis of the data is made possible.General quality of life scales provide data for an overall functional disability and disturbance, therefore they can be used for all segments of the population, for all diseases and disorders, and for various medical interventions.Disease-specific quality of life scales are specific scales for the disease under research, and may detect small variations (73). Quality of life scales frequently used for allergic rhinitis Medical Outcome Study, Short-Form 36 (SF-36), Short Form-12 (SF-12), Short Form-20 (SF-20)This is an overall health questionnaire used for detecting the effects of chronic conditions on functional heath status (74).The overall scale estimates physical and mental wellbeing of the individual.In case of AR, this scale was proven to differentiate healthy individuals from the patients, and it could be used successfully in the follow up of treatment (75).It is the most frequently used general quality of scale in the literature for investigation of AR patients. Glasgow Benefit InventoryThis is a frequently used 18-item questionnaire directed to overall, physical and social benefits of the treatment employed.It is mostly used in studies on hearing surgery and hearing aids (76). Sinonasal Outcome Test 20 and Sinonasal Outcome Test 22 (SNOT-22)This scale consists of the questions on nasal symptoms.It measures the severity of the symptoms as well as the emotional and mental significance of these symptoms for the patients.Symptom-related comorbidities are also included.SNOT-22 includes additional symptoms, it is proven to be reliable and valid, and it is an easy-to-use, popular scale used frequently in studies on rhinitis symptoms in order to obtain quantitative data (77). Rhinoconjunctivitis Quality of Life QuestionnaireIt is the most frequently used rhinitis-specific quality of life scale (78).It measures not only the rhinitis symptoms, but also selection of the activities that rhinitis influences, and the disability regarding those activities.This scale is employed for various rhinitis groups, and it has modifications for different symptoms. Rhinasthma Quality of Life QuestionnaireThe target population of this questionnaire is the asthma patients with comorbid AR.It has been proven to be reliable in patients with simple rhinitis and comorbid allergic asthma (79).Since those two disorders co-exist most of the time, Rhinasthma Quality of Life Questionnaire is frequently used in studies on those disorders. General Nasal Patient InventoryThis is a 30-item questionnaire for all rhinology patients.It measures quality of life in patients with any nasal disorder (80). Sinonasal-5 Quality of Life SurveyIt is a specific scale for children with persistent sinonasal symptoms.It has been used in treatment and follow up of pediatric sinonasal disorders.Turk Arch Otorhinolaryngol 2021 Turkish Guideline for Diagnosis and Treatment of Allergic Rhinitis 9 5.1.8.Rhinitis Control Assessment Test (RCAT)This scale is used to follow up the rhinitis symptoms after treatment.Higher scores in follow up has a significant correlation with disease control. Nasal Obstruction Symptom Evaluation ScaleThis is a nasal symptom assessment questionnaire used in adults.It is a reliable and valid 5-item nasal symptom scale that assesses nasal obstruction (81).Its validity has been proven in the follow up of the patients after surgery.It may be used in studies on sinusitis and rhinitis. Rhinosinusitis Disability IndexThis is a disease-specific questionnaire that measures the impact of the symptoms on daily activities, and their functional and emotional effects.It has been found beneficial in AR patients as well as rhinosinusitis patients (82). Rhinosinusitis Symptom InventoryThis scale includes major and minor symptoms of rhinosinusitis.Appendix 6.3.7.3.Pollen calendar.Pollens