Nonallergic Vasomotor Rhinitis
What is Nonallergic Vasomotor Rhinitis
Nonallergic Vasomotor Rhinitis
is an idiopathic condition characterized by perennial nasal congestion, rhinorrhea, and postnasal discharge. Ocular itching is noticeably absent. Typically, symptoms are increased early in the morning and aggravated by tobacco smoke, irritants, chemicals, perfumes, and various noxious odors. Symptoms are triggered by rapid changes in temperature. Mixed perennial rhinitis is diagnosed in allergic patients with prominent vasomotor symptoms.
The pathophysiology of Nonallergic Vasomotor Rhinitis is not well understood. However, a recent study reported that as compared with normal individuals, affected patients exhibited enhanced nasal responses to histamine; no increase in inflammatory cells; and nasal mucosal swelling after cold stimulation. Although cold stimulation of the feet normally causes mucosal contraction due to sympathomimetic stimulation, the opposite was observed in vasomotor rhinitis patients. This study suggests that vasomotor rhinitis patients have nasal sympathetic hyposensitivity resulting in unopposed parasympathetic stimulation
Symptoms of Nonallergic Vasomotor Rhinitis
Symptoms of nonallergic rhinitis often are indistinguishable from those associated with perennial allergic rhinitis. Therefore, the evaluation and treatment of nonallergic rhinitis can be challenging. Nonallergic rhinitis is defined as inflammation of the nasal mucosa that is not caused by sensitization to inhalant aeroallergens. Lack of allergic causation must be proven by the absence of skin test reactivity to a panel of common aeroallergens.
Treatment and Prevention of Nonallergic Vasomotor Rhinitis
The therapeutic approach to nonallergic nasal disorders is determined by findings derived from the diagnostic evaluation. Differentiation between inflammatory and noninflammatory nasal conditions is useful in selecting appropriate therapy.
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