Clinical Features, Investigations, and Management of Vasomotor Rhinitis

Definition and Pathophysiology

Vasomotor rhinitis is a non-allergic rhinitis characterized by nasal congestion, rhinorrhea, and postnasal drip in response to environmental stimuli. Unlike allergic rhinitis, it does not involve an immune response mediated by IgE antibodies.

Clinical Features

• Persistent nasal congestion
• Watery rhinorrhea
• Postnasal drip
• Frequent sneezing
• Nasal irritation triggered by temperature changes, strong odors, or stress

Investigations

Physical Examination

Patients typically exhibit swollen nasal turbinates without any signs of allergic inflammation.

Diagnostic Tests

• Nasendoscopy to evaluate nasal mucosa
• Skin prick tests to exclude allergic rhinitis
• Rhinomanometry to assess nasal airway resistance

Management Strategies

Medical Treatment

• Intranasal corticosteroids (e.g., fluticasone)
• Anticholinergic nasal sprays (e.g., ipratropium bromide)
• Oral antihistamines (for symptomatic relief)

Non-Pharmacological Approaches

• Avoidance of triggers (cold air, strong odors)
• Nasal saline irrigation for mucosal hydration
• Behavioral therapy for stress-induced symptoms

Conclusion

Vasomotor rhinitis can significantly impact quality of life, but effective management strategies—including medication and lifestyle adjustments—can help alleviate symptoms.