VASOMOTOR RHINITIS

Occurence:

• Non allergic rhinitis
• Overactivity of parasympathetic system – excessive secretion from the nasal glands, vasodilation and engorgement of nasal mucosa
• Nasal mucosa is hyper-reactive and responds to non-specific stimuli like change in temperature, dust, smoke etc

Symptoms:

• • Paroxysmal sneezing – bouts of sneezing  just after getting out of bed in the morning
  • Excessive rhinorrhea – profuse, watery
  • Nasal obstruction – more marked at night, alternates from side to side
  • Post nasal drip

Complications: nasal polyp, hypertrophic rhinitis, sinusitis

Treatment:

• Medical treatment: antihistaminic, oral nasal decongestants
• Surgical: vidian neurectomy

 Vidian neurectomy was first described for the treatment of intractable vasomotor rhinitis in the 1960s but fell into disrepute because of the recurrence of symptoms and significant complications. With subsequent improvements in the understanding of the nasal and sinus anatomy, endoscopic vidian neurectomy can now be performed with minimal dissection and morbidity

The principle underlying vidian neurectomy is to sever the preganglionic fibers that reach the sphenopalatine ganglion through the vidian nerve. Several routes have been described to approach the deep seated vidian nerve:

• Transantral [Classic & Subperiosteal]
• Transeptal
• Transpalatal
• Trans ethmoidal and
• Transnasal

The most popular approach to the vidian nerve is the Transantral route.

Exam Question

VASOMOTOR RHINITIS

• Non allergic rhinitis