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
• 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
Sequelae & Differential Diagnosis
Sequelae
Nasal polyp Hypertrophic rhinitis Sinusitis
Differential diagnosis
• Allergic rhinitis
• Non-allergic rhinitis with eosinophilia syndrome
• Rhinitis medicamentosa