Dr. Vishal Sharma - baixardoc

Non-infective Non-allergic

Rhintis

Dr. Vishal Sharma

1. Vasomotor rhinitis

2. Non-Allergic Rhinitis with Eosinophilia Syndrome

3. Occupational Irritant: flour, animal, wood, latex, paint

4. Rhinitis medicamentosa: decongestant nose drops

5. Drug-induced: propranolol, O.C.P., amytriptilline

6. Endocrine: hypothyroid, pregnancy, menstruation

7. Addiction: alcohol, tobacco

8. Non-airflow: tracheostomy, laryngectomy

9. Miscellaneous: honeymoon / emotional

Autonomic Innervation of Nose

• Deep petrosal nerve (Symp) + greater superficial

petrosal nerve (Para-symp) vidian nerve

pterygo-palatine ganglion nasal glands

• Sympathetic stimulation vasoconstriction +

ed nasal secretions

• Para-sympathetic stimulation vasodilatation +

ed nasal secretions

Vasomotor Rhinitis

• Caused by over activity of para-sympathetic

nervous system leading to:

• nasal congestion (due to nasal vasodilatation)

• nasal block (due to nasal vasodilatation)

• watery rhinorrhoea (due to ed nasal secretion)

Pathogenesis

Trigger Factors

1. emotional stress (hypothalamus controls

autonomic nervous system)

2. sudden change in temperature

3. humidity

4. blasts of cold air

5. dust

6. smoking & traffic fumes

Symptoms are perennial

• Nasal block (Blockers)

• Profuse watery rhinorrhoea (Runners)

Paroxysmal early morning sneezing

Post nasal drip

Turbinates congested & hypertrophied

Clinical Features

Diagnostic Nasal Endoscopy

Sequelae & Differential Diagnosis

Sequelae

Nasal polyp Hypertrophic rhinitis Sinusitis

Differential diagnosis

• Allergic rhinitis

• Non-allergic rhinitis with eosinophilia syndrome

• Rhinitis medicamentosa

Allergic N.A.R.E.S. Vasomotor

Allergen exposure

Yes No No

Nasal itch +++ + Minimal

ed sneezing +++ + Minimal

Nasal block ++ +++ +

Hyposmia ++ +++ +

Rhinorrhoea ++ ++ +++