Dysfonctionnement nasal chronique et obstruction des voies aériennes périphériques

Abstract

Allergic rhinitis often occur at the same time with many upper and lower airway diseases in which there is asthma. Many patients without clinical asthma may have an asymptomatic bronchial hyperreactivity and an allergic rhinitis at the same time. An overview of these actual knowledges is done including clinical, respiratory functional explorations, therapeutic studies, as well as those observed in chronic nasal dysfunctions (allergic or non allergic eosinophilic rhinitis, nasal polyposis, chronic rhinitis). Objectives. – The aim of this study is to determine bronchial hyperresponsiveness of a chronic nasal dysfunction population having allergic or non allergic rhinitis. Material and methods. – Retrospective study of respiratory functional explorations (using a methacholine provocation test) among non asthmatic patients consulting for rhinology-allergy diseases but with broncho-pulmonary symptomatology. Results. – It has been observed an allergic rhinitis population without upper bronchial hyperreactivity but with a small airway obstruction revealed or worsened during the methacholine bronchoprovocation test. Conclusion. – Chronic nasal dysfunction and small airway obstruction are correlated. This association shows an airway inflammation from the nose through the small bronchi. As upper bronchial hyperreactivity can precede asthma, a small airway obstruction could precede a bronchial hyperreactivity. Nasal chronic dysfunction treatment could act upon small airway obstruction, or central bronchial hyperreactivity or asthma appearance.