Otolaryngology Book


Vasomotor Rhinitis

Aka: Vasomotor Rhinitis
  1. Mechanism
    1. Autonomic Dysfunction
    2. Increased blood supply to nasal mucosa
  2. Epidemiology
    1. More common in women
    2. Perennial onset
  3. Types
    1. Runners (wet): Rhinorrhea predominates
    2. Dry: Nasal obstruction, airway resistance predominates
  4. Symptoms
    1. Characteristics
      1. Nasal obstruction and congestion
      2. Rhinorrhea
      3. Pruritus and sneezing may occur
    2. Provocative
      1. Odors (e.g. perfumes, Tobacco smoke)
      2. Alcohol
      3. Spicy food
      4. Humidity
      5. Temperature extremes (e.g. cold)
      6. Sunlight
      7. Gustatory Rhinitis (seen in older patients)
      8. Antihypertensive use
  5. Signs
    1. Normal nose exam
  6. Diagnosis
    1. Normal serum IgE
    2. Normal RAST testing or Allergy Testing
  7. Differential Diagnosis
    1. See Rhinitis
    2. Allergic Rhinitis
    3. Rhinitis Medicamentosa
  8. Management
    1. Avoid suspected triggers
    2. Nasal obstruction predominant
      1. Step 1: Intranasal Steroid
      2. Step 2: Intranasal Antihistamine (Azelastine)
    3. Rhinorrhea predominant
      1. Step 1: Intranasal Atrovent 0.03% two sprays bid-qid
      2. Step 2: Intranasal Intal
      3. Step 3: Intranasal Antihistamine (Azelastine)
    4. Rhinorrhea, sneezing and post-nasal drainage
      1. Step 1: Intranasal Antihistamine (Azelastine)
      2. Step 2: Intranasal Intal
      3. Step 3: Intranasal Steroid
  9. Management: Specific Cohorts
    1. Pregnancy
      1. Step 1: Nasal Saline
      2. Step 2: Intranasal Atrovent (Pregnancy Category B)
    2. Older patients
      1. Intranasal Atrovent
    3. Children
      1. Age over 2 years
        1. Congestion: Intranasal Steroid limited to Nasonex
        2. Sneezing: Intranasal Intal
      2. Age over 6 years
        1. Rhinorrhea: Intranasal Atrovent
        2. Congestion: Intranasal Steroid
        3. Sneezing: Intranasal Intal
  10. References
    1. Settipane (2001) Ann Allergy Asthma Immunol 86:494-507 [PubMed]
    2. Wheeler (2005) Am Fam Physician 72(6):1057-62 [PubMed]

Rhinitis, Vasomotor (C0035460)

Definition (MSH) A form of non-allergic rhinitis that is characterized by nasal congestion and posterior pharyngeal drainage.
Definition (MSHCZE) Vazomotorická rýma – rýma (rhinopathia, ev. rhinitis vasomotorica) projevující se záchvaty řídké sekrece z nosu a jeho ucpáním. Připomíná alergickou rýmu, patogeneticky se však uplatňují vegetativní vazomotorické reakce (spouštěné např. fyzikálními vlivy). Léčí se symptomaticky (dekongesce, lokální kortikoidy), ev. se provádějí chirurgické zákroky v nosní dutině. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI) Inflammation in the nasal cavity mucosa that results from the abnormal regulation of the blood flow in the nose. It may be caused by temperature fluctuations, air pollution, strong odors, and tobacco smoke. It results in chronic nasal congestion, sneezing, and running nose.
Concepts Disease or Syndrome (T047)
MSH D012223
ICD10 J30.0
SnomedCT 155537009, 266386004, 8229003
English Rhinitides, Vasomotor, Rhinitis, Vasomotor, Vasomotor Rhinitides, Vasomotor Rhinitis, vasomotor rhinitis, vasomotor rhinitis (diagnosis), Rhinitis, Vasomotor [Disease/Finding], Rhinitis;vasomotor, Vasomotor rhinitis, VMR - Vasomotor rhinitis, Vasomotor rhinitis (disorder), rhinitis; vasomotor, vasomotor; rhinitis, Vasomotor rhinitis, NOS
Dutch vasomotore rhinitis, rinitis; vasomotorica, vasomotorica; rinitis, Vasomotore rinitis, Rhinitis vasomotorica, Vasomotorische rhinitis
German vasomotorische Rhinitis, Rhinopathia vasomotorica, Rhinitis vasomotorica, Vasomotorische Rhinitis
Portuguese Rinite vasomotora, Rinite Vasomotora
Spanish Rinitis vasomotora, rinitis vasomotora (trastorno), rinitis vasomotora, Rinitis Vasomotora
French Rhinite angiospastique, Rhinite cholinergique, Rhinite spasmodique angiospastique, Rhinite vasomotrice
Swedish Rinit, vasomotorisk
Japanese ケッカンウンドウセイビエン, 血管運動神経性鼻炎, 鼻炎-血管運動性, 血管神経性鼻炎, 血管運動性鼻炎, 鼻炎-血管運動神経性
Finnish Vasomotorinen nuha
Czech Vazomotorická rinitida, rinitida vasomotorická, vasomotorická rinitida, vasomotorická rýma, vazomotorická rýma, rýma rhinopathia, rhinitis vasomotorica
Korean 혈관운동성 비염
Polish Nieżyt nosa naczynioruchowy
Hungarian Vasomotor rhinitis
Norwegian Rhinitt, vasomotorisk, Vasomotorisk rhinitt, Rhinitis vasomotorica
Italian Rinite vasomotoria
Derived from the NIH UMLS (Unified Medical Language System)

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