Constipation
The nose is blocked from one side, then from the other side, more often in the morning and when lying down.
CONDITION / CARRY
Vasomotor rhinitis.
Vasomotor rhinitis is a chronic runny nose and nasal congestion without allergy or infection that occurs in response to cold, strong odors, or a change in weather. It is treated with sprays, and when they do not help - surgically.
CONCEPTUAL VISUALIZATION- what is it
- Inflammation of the nasal mucosa with a runny nose and congestion, when there is no allergy and infection.
- How often
- Non-allergic rhinitis — about a quarter of all rhinitis; among them vasomotor — about 80%.
- Is it treated?
- Yes: first sprays and avoidance of triggers, and if they do not help - treatments on sinks.
- Who treats
- ENT doctor; surgeon - when an operation is required.
01 / WHAT IS ITWhat is
What is
vasomotor rhinitis.
Vasomotor rhinitis is the most common form of non-allergic rhinitis. The mucous membrane of the nose overreacts to common irritants: cold air, strong smells, smoke, weather changes. The blood vessels in it expand, the nose becomes stuffy, watery secretions appear.
It differs from allergic rhinitis in that allergy tests are negative, and symptoms do not depend on the season of flowering or contact with animals. Therefore, the diagnosis is made after allergy and infection have been ruled out.
Specialists increasingly call this condition non-allergic rhinopathy: it is more precisely described that the problem is the sensitivity of the nerve endings of the mucous membrane.
This is general information. The doctor will tell you what will help you after the examination.
02 / SIGNSHow
How
rhinitis manifests itself.
The diagnosis requires at least two nasal symptoms — without signs of infection and allergy.
Watery runny nose
Abundant clear discharge, especially in the cold or while eating.
Sneezing
Sneezing attacks in response to smell, smoke or temperature changes.
Mucus in the throat
Mucus flows down the back wall of the pharynx, causing coughing.
Enlarged shells
With a long course, the lower shells can increase in size, and the blockage becomes permanent.
Hypertrophy of shells03 / REASONSWhat
What
starts it.
The exact mechanism has not been clarified. There are known irritants to which the sensitive mucous membrane reacts, and several separate forms of non-allergic rhinitis.
irritants
Cold or dry air, strong smells, smoke, household chemicals, weather changes.
drops
Vasoconstricting drops, if used for a long time, themselves cause congestion after their action - the so-called medicinal rhinitis.
Hormones
A separate type is hormonal rhinitis, in particular during pregnancy.
Age and food
Another form is a runny nose during meals and in old age.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Vasomotor rhinitis does not require emergency care. But similar symptoms occur in other conditions, so a chronic runny nose should be shown to a doctor.
103 immediately if:
- nose bleeding does not stop after 15 minutes of pressing;
- swelling of the eyelids or deterioration of vision against the background of a runny nose.
See a doctor in the coming days if:
Only one side is blocked, bloody or purulent discharge appeared, pain in the face or the sense of smell disappeared. If the runny nose and congestion simply last for months, make an appointment for a scheduled consultation.
05 / DIAGNOSTICSHow the
How the
diagnosis is made.
- Conversation
When and for what symptoms occur, which drops and how long you use.
- Nasal endoscopy
Examination of the mucous membrane, shells, septum; search for polyps or other causes of blockage.
- Allergy test
Skin tests or blood tests — to rule out allergic rhinitis.
- CT scan if necessary
If sinusitis or other changes are suspected.
06 / TREATMENTHow
How
vasomotor rhinitis is treated.
Treatment begins with medication and lifestyle changes. Surgery is offered when symptoms persist despite treatment.
01
Without surgery
- Avoid irritants
- If possible, avoid known triggers - smoke, strong smells, cold air.
- Rinsing the nose
- Saline solutions reduce mucosal irritation.
- Sprays according to purpose
- Hormonal and antihistamine nasal sprays, which are selected by the doctor, are considered the first line.
- Be careful with drops
- Vasoconstrictor drops - only a short course, so as not to cause congestion after their action.
02
Surgery and procedures
For those who are not helped by medication.
- Reduction of lower shells
- If the main complaint is congestion, the shells are reduced: vasotomy or conchotomy with preservation of the mucous membrane.
- Intervention on the nerves
- Cryo- or radiofrequency action on the posterior nasal nerve reduces runny nose. For radiofrequency action in the summary of 5 studies (284 participants), 77% responded to treatment after 3 months; there is not much evidence yet.
- Overall result
- In a meta-analysis of 21 studies (2,091 patients) in chronic rhinitis, surgical and instrumental methods improved symptoms and quality of life more than drugs alone in those who were not helped by drugs.
07 / AT THE VALIKHNOVSKY CLINIC
How do we
How do we
treat it.
Vasomotor rhinitis, in which medication does not relieve congestion, is treated at Dr. Valikhnovsky's Institute of Surgery in the direction of "New Nose" — operations on the nasal turbinates.
DIRECTION TO THE CLINIC
A new nose
Shape, support and breathing of the nose: septum, concha, sinuses, consequences of injuries, failed operations and removal of tumors.
Go to direction
What do we do in this condition
- Vasotomy of the lower shells — reduces the swollen shell while preserving the mucous membrane.
- Shaver conchotomy under an endoscope — if the shell has already grown and does not shrink from the drops.
- Septoplasty with vasotomy — if the blockage is also reinforced by a curved partition.
Rostislav Valikhnovsky
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovsky Institute of Surgery.
How is the treatment in us
- ConsultationTalk about symptoms and drops, endoscopy of the nose.
- ExaminationIf necessary — CT to rule out sinusitis.
- PlanIs treatment with sprays enough, or is surgery on the shells necessary?
- OperationThrough the nostrils, without incisions on the face.
- RecoveryReviews after surgery; what is possible and what should be avoided, the doctor will explain individually.
08 / QUESTIONS AND ANSWERSFrequently asked
Frequently asked
questions.
Short answers. What is right for you, the doctor will tell you during the consultation.
How does vasomotor rhinitis differ from allergies?
With it, tests for allergies are negative, and symptoms are caused by non-specific irritants - cold, smells, weather. Therefore, the diagnosis is made after allergy has been ruled out.
Can vasomotor rhinitis be completely cured?
Symptoms can often be well controlled by avoiding triggers, using sprays, and reducing sinks if necessary. It is impossible to promise complete disappearance: everyone's course is different.
Why do the drops make it worse?
Vasoconstrictor drops with long-term use themselves cause congestion after the end of the action. Therefore, they are advised only for a short course.
Will a vasotomy help?
If the main complaint is congestion due to enlarged turbinates, usually yes: operations on the turbinates improve nasal breathing. It reduces runny nose less.
When is surgery necessary for vasomotor rhinitis?
When sprays and avoidance of irritants do not help, and the main complaint is congestion. An operation on the concha is offered after an examination, if it is seen that it is they that narrow the nasal passages.
How often is non-allergic rhinitis?
According to a review of 184 studies, the median prevalence of nonallergic rhinitis in adults is 12.0%; about a quarter of all rhinitises are non-allergic.
Sources
9 sources · reviews, guidelines and studiesShowCollapse
- Non-allergic rhinitis: Position paper of the European Academy of Allergy and Clinical ImmunologyAllergy, 2017doi:10.1111/all.13200 ↗
- Rhinitis 2020: A practice parameter updateJournal of Allergy and Clinical Immunology, 2020doi:10.1016/j.jaci.2020.07.007 ↗
- Nonallergic Rhinopathy: A Comprehensive Review of Classification, Diagnosis, and TreatmentJournal of Allergy and Clinical Immunology: In Practice, 2024doi:10.1016/j.jaip.2024.03.009 ↗
- Chronic Nonallergic RhinitisAmerican Family Physician, 2018pubmed.ncbi.nlm.nih.gov/30215894 ↗
- Worldwide prevalence of rhinitis in adults: A review of definitions and temporal evolutionClinical and Translational Allergy, 2022doi:10.1002/clt2.12130 ↗
- Surgical and instrumental options for chronic rhinitis: A systematic review and PRISMA meta-analysisEuropean Annals of Otorhinolaryngology, Head and Neck Diseases, 2023doi:10.1016/j.anorl.2023.10.009 ↗
- Posterior nasal nerve neurectomy for the treatment of rhinitis: a systematic review and meta-analysisEuropean Annals of Allergy and Clinical Immunology, 2023doi:10.23822/EurAnnACI.1764-1489.268 ↗
- Radiofrequency Neurolysis of the Posterior Nasal Nerve: A Systematic Review and Meta-AnalysisLaryngoscope, 2024doi:10.1002/lary.30911 ↗
- Surgical Management of Nonallergic RhinitisOtolaryngologic Clinics of North America, 2018doi:10.1016/j.otc.2018.05.010 ↗
The figures on the page are from these sources.
A runny nose that doesn't
go away for months?
Describe what your nose reacts to and what you have already tried. The doctor will tell whether treatment with sprays is enough or whether the shells should be reduced.