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Cryosurgery in obstructive non-allergic vasomotor rhinitis is a simple outpatient procedure with as good results as the more time-consuming and elaborate procedure of submucosal diathermy.
Our study comprised 50 patients of allergic and vasomotor rhinitis. Seventeen patients gave history of stress and strain hence they were given Geriforte in addition to Septilin. The results of therapy were judged on following criteria: i) Symptomatic improvement. ii) Appearance of nasal mucosa before and after the therapy. Thirty-nine patients (78%) were cured 100% as they had total relief from symptoms along with change of nasal mucosa from bluish to pink. Eight patients (16%) had about 75% improvement and 3 patients (6%) had only 50% improvement. These patients were advised to continue the therapy for a longer time (6-8 weeks). Of these, 4 patients showed further improvement. In our opinion, Septilin has proved very useful in cases of allergic and vasomotor rhinitis. The patients who have history of stress and strain may also need Geriforte in addition to Septilin.
Treatment of allergic vasomotor rhinitis is to be regarded with the factors that modify the symptomatology. In fact must be considered the morphological changes (septum deviation, adenoids, turbinates hypertrophy, polyps) infections (bacteria, chlamydiae, micetes) and specific allergens. Identification of allergens and sensitization threshold is to be studied; then specific hyposensitization will be assessed. In the present study, 68 subjects having nasal reactivity have been observed and underwent to different ways of treatment: 18 with permanent stenosis identified by rhinomanometry and not modified with vasoconstrictors were operated; 25 of the 50 patients with normal nasal cavities showed contemporary infections: after a specific antimicrobic or antimycotic treatment, a clear improvement was obtained documented by rhinomanometry before and after nasal stimulations. The 50 patients with normal morphology underwent a local hyposensitization against the allergens. As a matter of fact: a) in all cases a clear improvement was obtained in phase of increasing; b) after one year of maintainance just 13 over 50 (26%) returned to previous conditions. The Authors remark how local immunotherapy by the nasal way give good possibilities in a high percentage of cases in the following conditions: correct clinical evaluation, especially concerning the identification of factors determining vasomotor rhinitis; employment of precise techniques for diagnosis; observation of clinical data and results turning out from instrumental investigations, especially concerning the nasal provocation test evaluated by rhinomanometry.
Complaints of nasal obstruction following nasal trauma without any deformation have been noticed by rhinologists for many years. However, neither an epidemiologic nor a pathophysiologic connection has ever been established. The complaints and physical examination findings of these patients resemble those of vasomotor rhinitis. Only very few articles suggesting nasal trauma as a possible cause for vasomotor rhinitis have ever been published. We present a retrospective study that found 87 of 802 patients to suffer from vasomotor rhinitis following nasal trauma. No other factors known to cause vasomotor rhinitis were present in these patients. None had any previous nasal problems. We therefore suggest that nasal trauma was the causative factor in their vasomotor rhinitis.
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OBJECTIVE: To investigate the effect and mechanisms of botulinum toxin type A(BTA) on vasomotor rhinitis. METHOD: A retrospective study of 32 patients with vasomotor rhinitis who received BTA injection at 4 points in bilateral nasal cavities with 2.5 units at each point had been done. The state of rhinorrhea, nasal obstruction, sneeze and nasal mucosa edema of each patient were recorded and scored before and after the application of BTA respectively with follow-ups of 6-30 months. Twelve guinea pigs were randomly divided into 2 groups: BTA group and control group. Merocel sponge soaked with 10 units (0.2 ml) BTA was put into left nasal cavity under general anesthesia for one hour in BTA group. Saline replaced BTA in control group. The inferior turbinate mucosa of guinea pig ware harvested under general anesthesia at 7, 14, 28 days after BTA treatment and was observed with HE staining and electron microscope. RESULT: Rhinorrhea improved significantly in all 32 patients while sneeze, nasal obstruction and mucosa edema reduced partly. The reducing of rhinorrhea lasted averagely 6 weeks. Twelve patients had an episode of nasal dryness or increased rhinorrhea at the day of injection. No other complications were found. Seven, fourteen days after local BTA application, the degenerations of glandular epithelium and canal epithelium were observed in nasal mucosa of guinea pigs. Most of the glandular cells showed normal at 28 days after BTA treatment. CONCLUSION: BTA can induce the degeneration of glandular cells in nasal mucosa and thus obviously relieve over rhinorrhea of patients with vasomotor rhinitis.
Thirty patients with perennial vasomotor rhinitis were submitted to pharmacological tests to assess the autonomic responsiveness of extra-nasal and intra-nasal receptors to isoprenaline and phenylephrine by infusion, and to evaluate the effect of 14-days' treatment with mequitazine (5 mg twice daily) and placebo on clinical symptoms and on autonomic sensitivity. Isoprenaline induced a similar tachycardia in all patients, more pronounced than that observed in normal subjects, at the different times of testing, and also an increase in nasal resistance. With phenylephrine, marked bradycardia was observed, reflecting high vagal baroreflex sensitivity, and a transient decrease in nasal resistance was obtained. Mequitazine improved significantly the clinical symptoms but did not modify the autonomic receptivity. It is suggested that in patients with vasomotor rhinitis an autonomic dysfunction may play a role in a predisposing factor in nasal hyperreactivity with non-specific histamine release.
The ultrastructure of the respiratory nasal mucosa of patients suffering from vasomotor rhinitis was studied and compared with the reported ultrastructural findings in cases of chronic perennial allergic rhinitis. The principal ultrastructural differences were the absence of interendothelial gap junctions, the scarcity of eosinophils and plasma cells, and the absence of immunologically stimulated or degranulated mast cells in vasomotor rhinitis. These differences were discussed in the light of the known pathophysiologic facts.
In the AA's opinion the greatest number of rhinitis cases seen in the doctor's office are vasomotor rhinitis. The vasomotor response being determined because of the hyper-reactivity of the subject in face of several agents. After explanations of the fundamentals of their theory a perusal of the more frequent etiologies and differential symptoms are listed. The paper ends with a summary of the medications available, their pharmacologic activity and their respective indications.
Helium-neon laser LH-75 was used to treat 60 inbred mice and 62 patients with vasomotor rhinitis. The patients were given 10 laser sessions. In animals, all responses of T-lymphocytes were modified. Cyclic changes that developed during laser irradiation were accompanied by immunity suppression or activation. In patients, the count of T- and B-lymphocytes and the leucocyte migration inhibition reaction were measured. The patients with vasomotor rhinitis showed a significant increase of T-lymphocytes and a higher capacity of T-cells to form the migration inhibition factor. The efficacy of laser therapy of vasomotor rhinitis became optimal on irradiation day 6 or 7 and reached a maximum on day 10.
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The anterior ethmoidal nerve (AEN) contains parasympathetic fibres of sneeze reflex arc, it is possible to obtain improvement of clinical symptoms of vasomotor rhinitis through anterior ethmoidal neurectomy. The authors performed intranasal electrocoagulation of AEN on 30 patients with vasomotor rhinitis and followed up for nine months. The results revealed that the total effective rate was 86%, and the procedure provides a simple, effective and painless method for treating vasomotor rhinitis.
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Explore the source record for details and available documents.
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