World Allergy Forum: Non-Allergic Rhinitis and Polyposis
The Management of Non-Allergic Rhinitis
Paul Van Cauwenberge
Rhinitis is an inflammation of the lining of the nose, characterized by one or more of the following symptoms: nasal congestion, rhinorrhea, sneezing and itching. Rhinitis can be subdivided into three important categories: allergic, infectious, and other forms of rhinitis, the so called non-infectious non-allergic rhinitis.
In 1994, the first international consensus report was published presenting guidelines for the management of rhinitis. In 1999, these guidelines have been revised by an EAACI appointed expert group because the severe cases were not included, because new treatments were available since then and because new reports are published on activity and side effects.
In the guidelines proposed this year by an expert panel from the European Academy of Allergology and Clinical Immunology, the perennial non-allergic rhinitis was also evoked. The proposal of the experts regarding the management of nasal obstruction in perennial non-allergic rhinitis was as follows: if therapy is really needed, avoidance of the irritants when appropriate is first proposed.
If this is not sufficient, a topical corticosteroid is prescribed and eventually, after further examination to confirm the diagnosis, other therapies can be added such as decongestants. In case of a hyperplasic turbinate, surgical reduction of the turbinate is indicated. We will also discuss the possible role of capsaicin treatment and cryotherapy in the non-infectious non-allergic rhinitis.
Key-words: non-allergic rhinitis, cryotherapy, capsaicin, vidian neurectomy, nasal obstruction, rhinorrhea.