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A comparative immunological study of vasomotor rhinitis and pollinosis.

Differentiation between pollinosis and vasomotor rhinitis creates great diagnostic difficulties. The aim of this study was to conduct comparative immunological clinical studies contrasting these two distinct diseases. Thirty-one subjects with untreated pollinosis and 29 subjects with untreated symptoms of rhinitis were tested, determining their T and B lymphocyte counts and the counts of their subpopulations, the levels of immunoglobulin A, M, G, D and E, both separately and in total, and levels of both basal and whole histamine. The control group was comprised of 30 healthy subjects. The results of this study show that these two diseases differ from each other (p < 0.05) in the recorded levels of basal histamine, total IgE, and IgG, IgM and IgD, as well as the count of T-RFC lymphocytes, T lymphocytes with receptors for Fc IgG and B lymphocytes with superficial receptors for IgG. The most useful laboratory methods for diagnosing the difference between pollinosis and vasomotor rhinitis appear to be the determination of levels of basal histamine and IgD in the blood.

Diagnosis, Differential↗
PubMed1980

Treatment of allergic and vasomotor rhinitis by the local application of silver nitrate.

A new, simple and effective local treatment of allergic and vasomotor rhinitis is presented. Using 15 per cent silver nitrate, bilateral chemical cautery of the anterior part of the nasal septum and inferior turbinates has been carried out at weekly intervals on 1 to 5 occasions, in 41 cases. No distinction was made between allergic rhinitis and vasomotor rhinitis. 92.6 per cent of cases belonged to the age group of 11 to 50 years. There was a slight predominance of female over male patients in this study. Only those cases were selected who had sneezing as the presenting symptom, while 17 per cent of these patients also suffered from asthma. The eosinophil count in the blood was below 5 per cent in 73.2 per cent of cases, and was above 10 per cent in 9.8 per cent of cases. Eosinophils were present in the nasal secretions of of 66.6 per cent of patients. Intestinal parasites were detected in the stools of 19.5 per cent of cases. No significant quantity of methaemoglobin was detected in the blood of any patient. Silver nitrate was applied after topical anaesthesia with 4 per cent lignocaine solution. The majority of patients had 2 to 4 applications. 68.3 per cent of patients had good relief, particularly from sneezing and watering of the nose. If patients treated with only a single application of silver nitrate are excluded from the series, 79.4 per cent patients reported relief. Significantly, out of 7 cases who were suffering from allergic rhinitis as well as asthma, 57.1 per cent of cases had freedom from the asthma. Among 3 patients who had no relief with earlier intranasal hydrocortisone injections, 66.6 per cent cases had good relief with silver nitrate. One patient who had good relief from allergic rhinitis developed anosmia after this treatment and some patients experienced transient sneezing and rhinorrhoea after the application of silver nitrate. Long-term results are awaited and it is suggested that further studies are necessary regarding the number of applications, the interval between applications, the strength of the silver nitrate solution, and the possible use of other chemical or physical agents for this mode of treatment.

Administration, Topical↗
PubMed1980

Vasomotor rhinitis: neglected cause of nasal congestion.

Vasomotor rhinitis is a condition of chronic nasal congestion which is noninfectious and nonallergic. Its cause is thought to be an imbalance of autonomic control to the nasal mucosa. This disorder is a diagnosis of exclusion, and other causes of chronic nasal obstruction must be considered first. Treatment measures include avoidance of nonspecific stimuli which exacerbate symptoms and, for symptomatic relief, use of oral sympathomimetics. Antihistamine-decongestant combinations may be effective in some patients. Topical vasoconstrictors should not be used.

Denervation↗
PubMed2006

[The roles of three peptides in the pathogenesis of vasomotor rhinitis].

OBJECTIVE: To explore the possible roles of three neuropeptides in the pathogenesis of vasomotor rhinitis by studying the expression and distribution of neuropeptides in the mucosa of vasomotor rhinitis, such as Substance P(SP), calcitonin gene-related peptide (CGRP) and vasoactive intestinal peptide(VIP). METHOD: The mucosa specimens of thirty vasomotor rhinitis patients who had typical symptoms and signs were selected randomly as the experiment group and were divided into two subgroups depending on if received treatment or not. While the normal middle turbinate mucosa specimens of nine cases were selected as the control group. The expression and distribution of neuropeptides were examined by immunohistochemical SP method and computer image disposing and analyzing system. RESULT: The terminals of SP, CGRP and VIP in the treated experiment group wer and untreated experiment group were markedly increased in density of immunostaining compared to the control group,and the difference is significant (P < 0.01). CONCLUSION: Neuropeptides, such as SP, CGRP and VIP, may play important roles in the pathophysiological mechanism of vasomotor rhinitis.

Adolescent↗
PubMed2005

Nasal wall compliance in vasomotor rhinitis.

Nasal compliance is a measure related to the blood volume in the nasal mucosa. The objective of this study was to better understand the vascular response in vasomotor rhinitis by measuring nasal cross-sectional area and nasal compliance before and after mucosal decongestion in 10 patients with vasomotor rhinitis compared with 10 healthy subjects. Nasal compliance was inferred by measuring nasal area by acoustic rhinometry at pressures ranging from atmospheric pressure to a negative pressure of -10 cmH2O. Mucosal decongestion was obtained with one puff per nostril of 0.05% oxymetazoline. At atmospheric pressure, nasal cross-sectional areas were similar in the vasomotor rhinitis group and the healthy subject group. Mucosal decongestion did not induce any decrease of nasal compliance in patients with vasomotor rhinitis in contrast with healthy subjects. Our results support the hypothesis, already proposed, of an autonomic dysfunction based on a paradoxical response of the nasal mucosa in vasomotor rhinitis. Moreover, the clearly different behavior between healthy subjects and vasomotor rhinitis subjects suggests that nasal compliance measurement may therefore represent a potential line of research to develop a diagnostic tool for vasomotor rhinitis, which remains a diagnosis of exclusion.

Adult↗
PubMed1982

[Cryosurgery in vasomotor rhinitis].

Experience with cryotherapy of vasomotor rhinitis is reported. This proved effective with respect to occlusive and seromucous secretory components. The concomitant vasomotor phenomena such as cephalea and oviduct obstructions received some benefit. The probable mechanism of cryotherapeutic treatment and how to use the various probes are also illustrated.

Cryosurgery↗
PubMed1976

Intra-nasal beclomethasone dipropionate in vasomotor rhinitis.

Twenty-one patients with vasomotor rhinitis, with no relevant allergens known, completed a special double-blind trial of beclomethasone dipropionate aerosol (BDA) and placebo intra-nasally. Each patient took 200, 400 and 800 mug BDA and placebo during four consecutive 2-week periods and in different sequences. The symptom scores of the last week of each period of nasal blockage, watery secretion and sneezing were significantly reduced by all doses of BDA as compared with placebo. There were no differences between the effects of the different doses of BDA except for secretion, which was reduced more by using 800 than 200 mug. Cortisol in serum and 17-hydroxycorticosteroids in 24-hour urine were not significantly changed by BDA treatment and no increased frequency of pathogenic bacteria or fungi could be demonstrated in the nasal secretion. For treatment of patients with vasomotor rhinitis, intra-nasal BDA in a daily dose of 200 mug can be recommended when antihistamines, sympathomimetic drugs and sodium cromoglycate are not sufficiently effective.

17-Hydroxycorticosteroids↗
PubMed1985

Vasomotor rhinitis. A review and management by intranasal cryotherapy.

Vasomotor rhinitis is a common form of autonomic nasal dysfunction that is frequently confused with other nasal disorders. Although some clinical features are common to all forms of rhinitis, it is usually possible on the basis of the patient's history and a physical examination, together with the results of special investigations, to arrive at an accurate diagnosis in patients presenting with symptoms of nasal dysfunction. This article reviews the clinical and pathological features, differential diagnosis, and management of vasomotor rhinitis and reports a study of 110 patients treated between 1979 and 1983 by the application of cryotherapy to the mucosa overlying the inferior turbinate bones.

Adult↗
PubMed2005

Radiofrequency for the treatment of vasomotor rhinitis.

OBJECTIVES: We assessed the efficacy of submucosal application of radiofrequency to the inferior turbinate for the treatment of vasomotor rhinitis. PATIENTS AND METHODS: Twenty patients with vasomotor rhinitis (9 males, 11 females; mean age 29.2 years; range 20 to 40 years) were treated with radiofrequency applied to the inferior turbinate. Symptoms such as nasal obstruction, sneezing, and watery nasal discharge were graded with the use of a visual analog scale (VAS) before, and on days 1, 3, 7, 30, 60, 90, and 180 after the treatment. RESULTS: The severity of symptoms began to decrease following the first week after the application. Maximum relief was achieved between 30 to 60 days after the intervention. The highest rate of improvement (85.4%) was reported in sneezing, followed by nasal obstruction (76.4%) and nasal discharge (67.7%). The mean VAS scores showed a significant improvement in all symptoms between 7 to 180 days after the procedure (p<0.05). The rate of patient satisfaction was 90% for the relief of nasal obstruction and sneezing, and 80% for nasal discharge. Complaints about vasomotor rhinitis increased up to a severity near the pretreatment level in eight patients on the 180th postoperative day and the procedure was repeated. CONCLUSION: These findings indicate that radiofrequency may be used as an alternative treatment option in patients with vasomotor rhinitis.

Adult↗
PubMed2000

[Vasomotor rhinitis following endoscopic sinus surgery: 5 cases report].

OBJECTIVE: To investigate the possibility of endoscopic sinus surgery causing vasomotor rhinitis. METHOD: A retrospective study of 300 patients who received endoscopic sinus surgery. 5 cases out of 300 suffered from vasomotor rhinitis 1-3 weeks following endoscopic sinus surgery. Radio frequency cautery of agger nasi mucous was applied to all 5 patients. RESULT: After 4-6 months of follow-up, 4 cases out of 5 with vasomotor rhinitis were effective and 1 improved. CONCLUSION: Endoscopic sinus surgery may be causative factor for vasomotor rhinitis.

Adolescent↗