What are the AAO-HNSF guidelines on the diagnosis of allergic rhinitis?

Updated: Jan 02, 2020
  • Author: Quoc A Nguyen, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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In 2015 the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) released clinical practice guidelines for the diagnosis and management of allergic rhinitis. The recommendations are summarized below. [17]


A clinical diagnosis of allergic rhinitis should be made in patients with a history and physical examination consistent with an allergic cause and one or more of the following symptoms: (Recommendation)

  • Nasal congestion
  • Runny nose
  • Itchy nose
  • Sneezing

Findings consistent with an allergic cause include: (Recommendation)

  • Clear rhinorrhea
  • Nasal congestion
  • Pale discoloration of the nasal mucosa
  • Red and watery eyes

For patients with a clinical diagnosis of allergic rhinitis who do not respond to empiric treatment, or in situations in which the diagnosis is uncertain or the specific allergen is needed to target therapy, immunoglobulin E (IgE) (skin or blood) testing should be carried out by clinicians who can perform and interpret the testing. (Recommendation)

Sinonasal imaging should not be routinely performed in patients with symptoms consistent with a diagnosis of allergic rhinitis. (Recommendation)

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