Vasomotor rhinitis
Vasomotor rhinitis is a chronic disease caused by impaired vascular tone in the nasal cavity. It is similar in symptoms to allergic rhinitis, but has other causes.

What is vasomotor rhinitis

Vasomotor rhinitis is an inflammation of the nasal mucosa that is not associated with the ingestion of bacteria, virus or allergens. The disease is accompanied by severe and debilitating sneezing, copious discharge from the nasal cavity.

The disease is 10 times more common in residents of large cities. Men are more susceptible to the disease. They may develop a reflex form of the disease against the background of alcohol consumption.1.

Causes of vasomotor rhinitis in adults

Causes that cause inflammation of the nasal mucosa can be physiological, psychological or pharmacological. Among the main ones:

  • curvature of the nasal septum (congenital or acquired);
  • hormonal changes that manifest themselves against the background of diseases of the endocrine system, pregnancy or during puberty of adolescents;
  • gastroesophageal reflux disease.

The cause of vasomotor rhinitis in adults may be dependence on vasoconstrictor nasal drops and sprays. The disease can develop in patients while taking drugs used in psychiatry (gabapentin, chlorpromazine), drugs for the treatment of erectile dysfunction based on sildenafil, and some antihypertensive drugs.

In some cases, rhinitis develops under the influence of several factors and can be combined with an allergic form.

Symptoms of vasomotor rhinitis in adults

The main symptom of vasomotor rhinitis in adults is persistent respiratory failure. Nasal congestion occurs abruptly, often a symptom is observed in the morning after waking up. Respiratory failure is accompanied by sneezing and lacrimation, transparent discharge from the nasal cavity. Body temperature does not rise.

The clinical picture of vasomotor rhinitis in adults includes the following symptoms:

  • redness of the mucous membranes of the nose;
  • decreased quality of smell;
  • swelling in the nose;
  • a feeling of fullness in the region of the nasal septum;
  • mucous or watery discharge from the nose.

With the uncontrolled use of vasoconstrictor drops, itching occurs in the nasal cavity.

Treatment of vasomotor rhinitis in adults

In the treatment of vasomotor rhinitis, the main thing is to eliminate the root cause of the disorder. The methods of therapy used for other types of rhinitis are ineffective.

If vasomotor rhinitis progresses due to severe deformity of the nasal septum, the patient is indicated for surgery. In other cases, the disease is treated in a conservative way – medication.

Important! Before performing any surgical intervention for vasomotor rhinitis, the patient is warned about the likely instability of the result of the operation and the possible need for repeated interventions.

Diagnostics

The diagnosis is established on the basis of the patient’s complaints after collecting an anamnesis. It is confirmed by endoscopic examination of the nasal cavity and nasopharynx (using a special camera). If swelling of the lower turbinates is detected, a test is performed. A solution of xylometazoline or adrenaline is applied to the mucous membranes. In case of contraction of the nasal cavity, vasomotor rhinitis is diagnosed.

Other diagnostic options are used less frequently. The otolaryngologist may order a CT or x-ray of the sinuses. To rule out associated allergic rhinitis, an allergic examination is performed.

Drugs for vasomotor rhinitis

Today, for the treatment of vasomotor rhinitis, they use:

  • topical H1-blockers – antihistamines (azelastine, levokabastin);
  • InGKS (intranasal glucocorticosteroids) Avamys, Dezrinit, Nazarel, Nasonex, Nasobek, Nozefrin, Flixonase (put the market as it is, and remove their names from the text);
  • topical mast cell membrane stabilizers (cromoglycic acid derivatives).

Drug treatment is always selected individually and depends on the causes of rhinitis. There is no single treatment regimen for the disease. Frequent rinsing of the nasal cavity with iso- and hypertonic solutions of sea water helps to relieve symptoms.2.

The use of drugs to eliminate symptoms in the curvature of the nasal septum is impractical, in which case surgery is indicated3.

If vasomotor rhinitis appeared due to the abuse of nasal vasoconstrictor drops, they will have to be completely abandoned.

Vasomotor rhinitis in pregnant women resolves after childbirth, but drug treatment is also possible4.

Inhalations for vasomotor rhinitis

Nebulizer inhalations are not indicated for vasomotor rhinitis. If you use such equipment, the particles of the medicinal solution will be small and will not linger in the nasal cavity and sinuses, they will immediately enter the respiratory tract. Steam inhalation is a dangerous procedure that can cause burns to the upper respiratory tract.

Folk remedies

One should not expect an effect from the use of alternative medicine methods. Only in some cases, according to the doctor’s prescription, with vasomotor rhinitis, herbal medicines can be used, having previously eliminated the risk of allergic reactions. Means containing herbal ingredients are used in a short course – no more than 10-14 days. With prolonged use, they have a negative effect on the mucous membranes.

Prevention of vasomotor rhinitis in adults

There is no specific prevention of vasomotor rhinitis. You can reduce the risk of developing the disease by eliminating the factors that provoke it:

  • give up nicotine addiction and alcohol consumption;
  • eliminate stress;
  • adjust the hormonal background;
  • do not use vasoconstrictor nasal drops without a doctor’s prescription for a long course.

Popular questions and answers

We have discussed issues related to vasomotor rhinitis in adults with Candidate of Medical Sciences, otorhinolaryngologist, phoniatrist Anna Kolesnikova.

What complications can vasomotor rhinitis give?
Symptoms of vasomotor rhinitis can significantly reduce the quality of life. Often, against the background of the disease, snoring, obstructive sleep apnea (spasm of the upper respiratory tract) is manifested. The patient is worried about a prolonged dry cough, middle ear congestion appears, and the development of otitis media is not excluded.

Against the background of prolonged edema and irritation of the mucous membranes, the growth of polyps is possible. Vasomotor rhinitis increases the likelihood of developing polyposis rhinosinusitis.

Is vasomotor rhinitis contagious?
Vasomotor rhinitis is not contagious to others.
Which doctor treats vasomotor rhinitis?
Vasomotor rhinitis is treated by an otolaryngologist. If the disease occurs in conjunction with allergic rhinitis, you will need to consult an allergist. If vasomotor rhinitis is a consequence of gastroesophageal reflux disease, treatment by a gastroenterologist is necessary.
Can chronic vasomotor rhinitis be cured?
In some cases, it is possible to cure chronic vasomotor rhinitis by eliminating the causes of the disease, for example, when the disease develops against the background of long-term use of drugs from certain groups.

If the cause of the disease is the curvature of the nasal septum, surgery will help eliminate its symptoms, but reflex edema may return due to the instability of the effect of the operation.

  1. Vasomotor rhinitis: pathogenesis, diagnosis and treatment principles (clinical guidelines). Edited by A.S. Lopatin. https://pharm-spb.ru/docs/lit/Otorinolaryngologia_Rekomendazii%20po%20diagnostike%20i%20lecheniyu%20vazomotornogo%20rinita%20(ROR,%202014).pdf
  2. Lopatin A.S. Treatment of vasomotor rhinitis: international trends and Russian practice // MS. 2012. No. 11. https://cyberleninka.ru/article/n/lechenie-vazomotornogo-rinita-mezhdunarodnye-tendentsii-i-rossiyskaya-praktika
  3. Kryukov A. I., Tsarapkin G. Yu., Zairatyants O. V., Tovmasyan A. S., Panasov S. A., Artemyeva-Karelova A. V. Modern aspects of surgical treatment of vasomotor rhinitis. Russian rhinology. 2017;25(2):10-14. https://doi.org/10.17116/rosrino201725210-14
  4.  Dolina IV Vasomotor rhinitis in pregnant women / IV Dolina // Medical Journal. – 2009. – № 3. http://rep.bsmu.by/bitstream/handle/BSMU/2881/Vasomotor%20rhinitis%20%20pregnant%20women.Image.Marked.pdf?sequence=1&isAllowed=y

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