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At least 19 recordsLinked to original sources
PubMed1987

Nasal disorders in children. Allergic rhinitis, vasomotor rhinitis, and nasal polyps.

Although the symptoms of allergic rhinitis, vasomotor rhinitis, and nasal polyps are similar, these conditions usually require different treatment. Allergic rhinitis responds best to environmental control, avoidance of allergens and irritants, and intermittent use of medication. Hyposensitization therapy is useful in some patients. Vasomotor rhinitis is usually helped by avoidance of environmental factors, but medical or surgical management is sometimes appropriate. Nasal polyps can be removed surgically.

Child↗
PubMedDate not supplied

Electrophoretic evaluation of nasal discharge in patients with allergic rhinitis and vasomotor rhinitis.

BACKGROUND: Allergic rhinitis and vasomotor rhinitis are two common diseases that have similar symptoms and physical findings. This study was designed to assess the efficacy of electrophoretic analysis of nasal discharge for the differential diagnosis of allergic rhinitis and vasomotor rhinitis. METHODS: Two different groups of patients with allergic rhinitis (n = 18) and with vasomotor rhinitis (n = 18) diagnosed by current methods and 10 healthy subjects as a control group were included in this study. Component analyses of proteins in nasal wash were made by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. RESULTS: The mean levels of total protein, 66-kDa proteins and 26-kDa proteins (277.2 +/- 9 microg/mL, 114.5 +/- 9 microg/mL, and 67.0 +/- 4 microg/mL, respectively), in nasal washing samples of patients with allergic rhinitis were found to be higher than in the samples, (222.0 +/- 6 microg/mL, 65.6 +/- 6 microg/mL, and 42.9 +/- 4 microg/mL respectively) obtained from patients with vasomotor rhinitis. The control group showed the lowest rate of these proteins (167.8 +/- 7 microg/mL 34.3 +/- 3 microg/mL, and 25.0 +/- 3 microg/mL, respectively). The differences between mean levels of these proteins in all groups were statistically significant (p < 0.05). CONCLUSIONS: These findings indicate that electrophoretic analysis of nasal discharge can be used for the diagnosis of allergic rhinitis and vasomotor rhinitis. However, further studies are needed to standardize the technique of nasal wash and to determine the range of proteins in nasal secretions that will confirm the diagnosis.

Adolescent↗
PubMed1986

Vasomotor rhinitis.

Vasomotor rhinitis is a nonallergic, noninfectious cause of nasal obstruction and rhinorrhea. The etiology is believed to be an imbalance of the autonomic neural supply to the nasal mucosa with resultant vasodilation and hypersecretion. Management hinges on identification of a treatable diagnostic entity, such as rhinitis medicamentosa or allergic rhinitis. Psychotherapy, medical therapy, and surgery all have roles in the treatment of vasomotor rhinitis. Response to therapy is often disappointing.

Autonomic Nervous System↗
PubMed1995

[Differentiation between allergic rhinitis and vasomotor rhinitis by electrophoretic evaluation of the protein in pituita].

Application of trichloro-acetic acid (TCA) to the inferior turbinates is being performed at our hospital to treat allergic rhinitis. However, some patients have continous rhinorrhea even though the provocation test after treatment was negative. Electrophoretic studies were performed on the nasal discharge of such continuous rhinorrhea patients to analyze its protein components, albumin and 23kD protein. The results showed that the pituita in the unimproved cases with negative provocation result was similar in nature to the pituita in vasomotor rhinitis patients. It was concluded that the proteins in the pituita were not attributable to an antigen-antibody reaction, because the provocation test was negative, but they were the result of angiogenic factors (= vasomotor rhinitis). Thus it appears that allergic rhinitis can be classified into two types: genuine allergic rhinitis and allergic rhinitis associated with vasomotor rhinitis. TCA therapy was not effective in the cases of allergic rhinitis with vasomotor rhinitis, because they had a pathophysiological feature of vasomotor rhinitis. Genuine allergic rhinitis can be differentiated from vasomotor rhinitis clinically by measuring albumin and 23kD protein in pituita. It was concluded that measurement of 23kD protein concentrations in pituita is effective for determining indications for TCA chemotherapy and evaluating its clinical results.

Albumins↗
PubMed1991

[Differentiation between allergic rhinitis and vasomotor rhinitis. Light and electron microscopic studies].

The pathological changes of nasal mucosa from allergic rhinitis and vasomotor rhinitis were observed. The results showed that the general characteristic was vascular dilatation with increased permeability and glandular proliferation with increased secretory activity. The pathological difference between mucous membranes of allergic and vasomotor rhinitis were mainly cellular infiltration and degree of damage on vascular wall. In allergic rhinitis there were more eosinophils, basophils, neutrophils and some mast cells and plasma cells in nasal mucosa. Gap formation in capillary wall was found in allergic nasal mucosa, there were less cellular infiltration and no gap formation in vasomotor rhinitis.

Diagnosis, Differential↗
PubMed2005

Vasomotor rhinitis.

Vasomotor rhinitis affects millions of Americans and results in significant symptomatology. Characterized by a combination of symptoms that includes nasal obstruction and rhinorrhea, vasomotor rhinitis is a diagnosis of exclusion reached after taking a careful history, performing a physical examination, and, in select cases, testing the patient with known allergens. According to a 2002 evidence report published by the Agency for Healthcare Research and Quality (AHRQ), there is insufficient evidence to reliably differentiate between allergic and nonallergic rhinitis based on signs and symptoms alone. The minimum level of diagnostic testing needed to differentiate between the two types of rhinitis also has not been established. An algorithm is presented that is based on a targeted history and physical examination and a stepwise approach to management that reflects the AHRQ evidence report and U.S. Food and Drug Administration approvals. Specific approaches to the management of rhinitis in children, athletes, pregnant women, and older adults are discussed.

Adrenal Cortex Hormones↗
PubMed1993

Comparison of allergic rhinitis and vasomotor rhinitis patients on the basis of a computer questionnaire.

From 1 July 1990 to 31 December 1991, all patients referred to the Allergy Section of the ENT Department, University Hospital, Lund, Sweden, (n = 678) answered a 134-item questionnaire presented on the screen of a personal computer by pressing Y (for yes) or N (for no) on the keyboard. The objective of this study was to compare the questionnaire responses from patients with allergic rhinitis (AR) with those of patients with perennial nonallergic rhinitis or vasomotor rhinitis (VMR). Nasal blockage was the predominant symptom in the VMR group, whereas the AR patients mainly suffered from eye irritation, sneezing, and, to some extent, rhinorrhea. Concomitant asthma was more prevalent in the AR group than in the VMR group, whose histories were characterized by symptoms associated with airway infections. About 60% of both groups reported problems with such nonspecific airway irritants as cigarette smoke and perfumes. With respect to the diagnostic reliability of the history, in the AR group the order of accuracy (according to the skin prick test results) of reported hypersensitivity to allergens was as follows: cat > timothy > birch > dust mite > mugwort. A history of hypersensitivity to molds as a cause of symptoms was of no diagnostic value. The findings suggest that there are several differences in the medical histories of AR and VMR patients that merit further investigation.

Adult↗
PubMed1978

[Vasomotor rhinitis and vasomotor tests (author's transl)].

The classification of types of vasomotor rhinitis remains controversial. Too frequently, the presence of salvoes of sneezing leads to a diagnosis of allergy. The authors point out the only relatively accuracy of skin tests and show that marked local histamine liberation may occur in the absence of allergy. They have perfected a battery of vasomotor tests using nicotinic acid, histamine, 48/80 and acetylcholine. On this basis, they propose a pragmatic clinical classification of types of vasomotor rhinitis. Underlying tendency to tetany is the most common aetiology, going hand in hand with increased histamine sensitivity.

Acetylcholine↗
PubMed2005

Open-label evaluation of azelastine nasal spray in patients with seasonal allergic rhinitis and nonallergic vasomotor rhinitis.

OBJECTIVE: The objective of the study was to evaluate the effectiveness of azelastine (Astelin) nasal spray, a topical second-generation antihistamine, in the treatment of symptoms of seasonal allergic rhinitis, seasonal allergic rhinitis with nonallergic triggers (mixed rhinitis), and nonallergic vasomotor rhinitis. RESEARCH DESIGN AND METHODS: A total of 2343 primary care physicians, allergists, ENT specialists, and other health professionals participated in this 2-week, open-label evaluation of azelastine nasal spray. Data were collected through a physician questionnaire that included patient demographics, rhinitis diagnosis, medication history, and inclusion/exclusion criteria; and two patient questionnaires that included symptom history, response to previous rhinitis medications, symptom control, and level of satisfaction with azelastine nasal spray. A completed physician questionnaire and two completed patient questionnaires were required for each patient to be included in the analysis. Patients who qualified for enrollment were given open-label azelastine nasal spray and instructed to administer 2 sprays per nostril twice daily for 2 weeks. RESULTS: A total of 1225 health professionals enrolled 7864 patients into the study. Completed physician and patient questionnaires were returned by 1081 health professionals and 5073 patients, 4364 of whom used azelastine nasal spray as their only rhinitis medication during the 2-week study period. The patients were predominantly caucasian (82.6%) and female (61.1%), with a mean age of 50 years. The majority had a diagnosis of mixed rhinitis (51.5%), followed by seasonal allergic rhinitis (32.3%), and nonallergic (vasomotor) rhinitis (16.2%). After 2 weeks of treatment, the percentage of patients reporting some control or complete control of individual symptoms ranged from 78% for postnasal drip in patients with nonallergic vasomotor rhinitis to 90% for sneezing in patients with seasonal allergic rhinitis. More than 85% of patients who reported difficulty sleeping or impairment of daytime activities due to rhinitis symptoms had improvement in these parameters. Azelastine nasal spray was well tolerated, the discontinuation rate due to adverse events was 2.3%. CONCLUSIONS: Azelastine nasal spray was reported to control all rhinitis symptoms, including nasal congestion, regardless of rhinitis diagnosis during the 2-week study period. Patients with seasonal allergic rhinitis and patients with seasonal allergic rhinitis plus nonallergic triggers were identified as patient types most likely to respond to azelastine nasal spray.

Administration, Intranasal↗
PubMedDate not supplied

The effect of intranasal injection of botulinum toxin A on the symptoms of vasomotor rhinitis.

PURPOSE: Vasomotor rhinitis (VMR) is a common disease that is unrelated to allergy, infection, structural abnormalities, and systemic diseases. Patients with VMR usually complain of nasal obstruction accompanied by profuse watery nasal discharge. The exact pathophysiologic mechanisms of VMR are not known. Some studies suggested that it results from an autonomic nervous system dysfunction. No effective long-term treatment modalities exist for the VMR. MATERIALS AND METHODS: Thirty patients with VMR were randomly and equally divided into 2 groups. The mean age was 38.46 years (range, 18-59 years; 1 men, 14 women) for group 1 and 41.60 (range, 29-62 years; 4 men, 11 women) for group 2. Five patients with VMR were accepted as a control group. Fifteen patients were injected 10 U of botulinum toxin A (BTX-A) (group 1) and patients in group 2 were injected 20 U to inferior and middle turbinates. Control patients were injected with saline solution into the inferior and middle turbinates. RESULTS: Total symptom scores generally decreased after the first week and increased after the eighth week. The symptoms of patients (nasal obstruction, sneezing, nasal discharge, and nasal itching) were scored from 1 to 5, with 1 as less severe and 5 as most severe. The statistical significance of the results was analyzed using Kruskal-Wallis and Mann-Whitney U test. When total symptom scores of group 1 (10 U BTX-A) were compared with the control group, there was a statistically significant difference regarding symptoms scores at all control weeks. There was also a statistically significant difference for total symptom scores between group 2 and control group, except for the first control week. CONCLUSION: Intranasal injection of BTX-A is a highly effective, safe, and simple symptomatic treatment modality with a long-lasting effect for patients with VMR. Botulinum toxin A may be a good alternative especially for the treatment of resistant VMR cases.

Administration, Intranasal↗
PubMed1986

[Clinical, diagnostic and therapeutic aspects of non-allergic forms of rhinitis: non-allergic rhinitis with eosinophilia syndrome and vasomotor rhinitis].

Two clinical syndromes of non-allergic rhinitis -- NARES and vasomotor rhinitis -- were studied. In recent years there has been a moderate statistical increase in both conditions which are still not easily diagnosed or treated, given the fact that they are often confused with allergic rhinitis. In this context a brief review of aetiopathogenic and physiopathological factors is followed by the suggestion of certain elements that may be assessed in order to obtain a more correct classification and diagnosis. Finally the drugs providing a more effective and long-lasting cure are listed.

Aerosols↗
PubMed1995

Anterior ethmoidal glycerol rhizotomy for vasomotor rhinitis.

The treatment of vasomotor rhinitis by anterior ethmoidal glycerol rhizotomy (AEGR) was assessed in 78 patients with a follow-up period ranging from 12 to 15 months. The reduction of nasal hypersecretion obtained with AEGR was maintained over six months. At the final assessment, sixty patients (76.9%) reported complete relief of symptoms and are taking no medications; seven (8.9%) were improved with minimal drug therapy required for symptom relief; and 11.9% had poor results with unsatisfactory control even with medication. Nineteen patients required a second treatment because of an initial suboptimal infection or recurrence. Apparently, this method offers those patients with vasomotor rhinitis a valid option for treatment of clinical symptoms, with the additional benefit of experiencing no serious complications when compared with vidian neurectomy.

Adult↗