Clinical Features, Investigations, and Management of Vasomotor Rhinitis

Introduction

Vasomotor rhinitis is a non-allergic, non-infectious rhinitis characterized by chronic nasal congestion, rhinorrhea, and sneezing. It is often triggered by environmental factors such as temperature changes, strong odors, and stress.

Clinical Features

• Persistent nasal congestion
• Watery rhinorrhea
• Frequent sneezing
• Postnasal drip
• Absence of allergic or infectious causes

Investigations

Diagnosis is primarily clinical but may include:

• Nasendoscopy to evaluate nasal mucosa
• Allergy testing to rule out allergic rhinitis
• Rhinomanometry to assess nasal airflow

Management

Medical Treatment

Initial management includes:

• Intranasal antihistamines (e.g., azelastine)
• Intranasal corticosteroids (e.g., fluticasone)
• Anticholinergic nasal sprays (e.g., ipratropium bromide)
• Avoidance of triggering environmental factors

Surgical Options for Refractory Cases

In patients unresponsive to medical therapy, surgical interventions may be considered:

• Inferior turbinate reduction: Helps to decrease nasal obstruction.
• Vidian neurectomy: Aimed at reducing excessive nasal secretion.
• Septoplasty: Indicated if nasal obstruction is worsened by a deviated septum.
• Radiofrequency ablation: Minimally invasive method to reduce turbinate hypertrophy.

Conclusion

Vasomotor rhinitis can significantly impact the quality of life. While medical therapy remains the cornerstone of treatment, surgical options may offer relief for refractory cases.