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ORL J Otorhinolaryngol Relat Spec 2021;83(4):252-257. Epub 2021 Mar 5.

Otorhinolaryngology Division, Department of Surgery, University of Eastern Piedmont "A. Avogadro", Novara, Italy.

Introduction: Radiofrequency turbinate volume reduction (RFTVR) is an effective treatment of inferior turbinate hypertrophy. RFTVR can reduce epithelial cell alterations in nasal mucosa. The aim of this observational study was to evaluate the effects of RFTVR on nasal obstruction and cytology, stratifying for different types of rhinitis. Read More

CMAJ 2020 Nov;192(45):E1403-E1406

Division of Allergy and Immunology (Pham), Department of Medicine, McGill University Health Centre, Montréal, Que.; Division of Neurology (Gosselin-Lefebvre), Centre hospitalier universitaire de Québec-Hôpital de l'Enfant-Jésus, Université Laval, Québec, Que.; Division of Allergy and Immunology (Pourshahnazari), University of British Columbia; Division of Neurology (Yip), Vancouver General Hospital, University of British Columbia, Vancouver, BC.

Curr Mol Pharmacol 2020 Jul 27. Epub 2020 Jul 27.

Department of Medical Biology, Gaziantep University Faculty of Medicine, Gaziantep. Turkey.

Background: Rhinitis medicamentosa, also known as 'rebound congestion,' is inflammation of the nasal mucosa caused by the overuse of topical nasal decongestants. Although local decongestants resolve the initial nasal obstruction, the overuse causes rebound obstruction. However, how the overuse of the decongestant causes rhinitis medicamentosa is not known. Read More

Vestn Otorinolaringol 2020 ;85(3):75-82

Volgograd State Medical University of the Ministry of Health of Russia, Volgograd, Russia.

One type of non-allergic non-infectious rhinitis is represented by a heterogeneous group of rhinitis medicamentosa, which can be divided into several pathogenetic types. The most common rebound nasal congestion associated with the use of topical decongestants. Excessive use of intranasal decongestants leads to a decrease in the number of alpha-adrenoreceptors on the surface of cell membranes and uncoupling their connection with the G-protein and the development of tachyphylaxis. Read More

Rhinology 2020 Jun;58(3):233-240

"A. Gemelli" Hospital Foundation, IRCCS, Head and Neck Surgery Area, Institute of Otorhinolaryngology, Catholic University of the Sacred Heart. Rome, Italy.

Background: the primary end point of our study was to define risk factors and identify the underlying conditions that may have led to the abuse of vasoconstrictors in rhinitis medicamentosa. Moreover, we analysed factors that may influence the vasoconstrictors discontinuation.

Methodology: this was a prospective case-control observational study. Read More

J Otolaryngol Head Neck Surg 2019 Dec 9;48(1):70. Epub 2019 Dec 9.

Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.

Background: Rhinitis medicamentosa is a non-allergic form of rhinitis that is typically caused by prolonged use of topical nasal decongestants. This condition commonly affects young adults and treatment is not trivial. We aimed to survey Canadian Otolaryngologists to determine practice patterns and their opinions regarding this under-studied condition. Read More

Cochrane Database Syst Rev 2019 11 2;2019(11). Epub 2019 Nov 2.

Academic Medical Centre, Department of Otorhinolaryngology, Meibergdreef 9, A2-234, 1105 Az, Amsterdam, Netherlands.

Background: Non-allergic rhinitis is defined as dysfunction and non-infectious inflammation of the nasal mucosa that is caused by provoking agents other than allergens or microbes. It is common, with an estimated prevalence of around 10% to 20%. Patients experience symptoms of nasal obstruction, anterior rhinorrhoea/post-nasal drip and sneezing. Read More

Ann Otol Rhinol Laryngol 2020 Feb 4;129(2):164-169. Epub 2019 Oct 4.

Boston University School of Medicine, Boston, MA, USA.

Objective: The objective of this study was to determine whether patients with rhinitis medicamentosa (RM) have an increased odds of having an opioid use disorder (OUD) and which characteristics may predict this association.

Methods: The authors conducted a retrospective case control study of patients 18 years and older who presented to the otolaryngology clinic at an academic medical center from January 2013 through December 2017. Cases, defined as patients who presented with excessive decongestant nasal spray usage based on history, were matched to control patients who presented with chronic rhinitis and did not report regular nasal decongestant usage. Read More

Eur Arch Otorhinolaryngol 2019 Nov 29;276(11):3123-3130. Epub 2019 Aug 29.

Department of Ear Nose Throat, Ministry of Health, Ümraniye Education and Research Hospital, Istanbul, Turkey.

Objective: Rhinitis medicamentosa is drug-induced rhinitis which occurs by prolonged and overdose usage of topical nasal decongestants. There is not much of treatment choice rather than nasal steroids. In this pathological study, we have been aimed to represent the healing effects of xylitol on damaged nasal mucosa due to rhinitis medicamentosa. Read More

Ir Med J 2019 02 14;112(2):874. Epub 2019 Feb 14.

Edinburgh Medical School, Scotland

Aim Report successful application of UV endonasal phototherapy as a treatment for severe rhinitis medicamentosa and allergic rhinitis. Methods Allergic rhinitis confirmed by history and skin prick testing; rhinitis medicamentosa based on history. Both confirmed at nasendoscopy. Read More

Otolaryngol Head Neck Surg 2019 03 16;160(3):429-438. Epub 2018 Oct 16.

1 Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA.

Objective: Rhinitis medicamentosa (RM) is a common condition resulting from overuse of topical nasal decongestants. Despite the prevalence in otolaryngologic practice, a clear treatment protocol has not been established. Our objective was to review the current published literature pertaining to the treatment of RM with the possibility of finding data that support one treatment over another. Read More

J Biol Regul Homeost Agents 2017 12 27;31(4 Suppl 2):55-62. Epub 2017 Dec 27.

Unit of Otolaryngology, University Campus Bio-Medico of Rome, Italy.

This study was designed to prospectively evaluate the role of nebulized hyaluronic acid (HA) administered for 10 days as treatment for patients with rhinitis medicamentosa (RM). RM is a pathological condition of the nasal mucosa induced by prolonged, excessive or improper use of topical decongestants. It is characterized by persistent nasal congestion that can lead the patient to increase the frequency of application and the quantity of the substance being applied, resulting in dependence on topical nasal decongestants. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017 Nov;52(11):872-875

Department of Otorhinolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China.

Rhinitis medicamentosa (RM) refers to nonallergic inflammation in the nasal mucosa which is caused by the abuse of nasal decongestant and it often occurs in patients with allergic/nonallergic rhinitis along with nasal congestion. RM is characterized by nasal congestion based on long-term use of nasal decongestant, without rhinorrhoea or sneezing. The signs of RM include nasal swelling, thickening, loss of elasticity, and loss of sensitivity to the decongestant. Read More

Asian Pac J Allergy Immunol 2016 Mar;34(1):30-7

Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background: The recommended drug for moderate to severe chronic rhinitis is intranasal steroids (INS). However, nasal congestion could be refractory and need additional treatments.

Objective: We sought to explore the benefit of oxymetazoline (Oxymet) plus INS on nasal congestion without inducing rhinitis medicamentosa. Read More

Auris Nasus Larynx 2016 Dec 2;43(6):685-8. Epub 2016 Mar 2.

Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Objective: To better understand the causes of the exacerbation of rhinitis medicamentosa (RM) induced by oxymetazoline (OMZ) or benzalkonium chloride (BKC), we examined the impact of pretreatment with OMZ or BKC on cultured human nasal epithelial cells. We also examined the effect of mometasone furoate (MF) on the cultured human nasal epithelial cells treated with OMZ or BKC.

Methods: Cells of the human nasal epithelial cell line HNEpC were treated with OMZ or BKC, and the OMZ- and BKC-induced expression of histamine H1 receptor (H1R) mRNA was assayed using real-time polymerase chain reaction. Read More

Dermatol Online J 2015 Jan 1;21(3). Epub 2015 Jan 1.

SAUSHEC.

Background: Rebound erythema secondary to use of topical brimonidine in the setting of rosacea is an important, possibly significantly distressing potential side effect that may be under-reported; there is little photo-documentation in the literature to date. This article documents such a case.

Observations: A 28-year-old woman (Fitzpatrick II) with a long-standing history of untreated rosacea presented for initiation of treatment of what was noted to be primarily erythematotelangiectatic rosacea and was offered Mirvaso for daily use. Read More

Eur J Pharmacol 2014 Nov 18;742:153-7. Epub 2014 Sep 18.

Mustafa Kemal University, School of Medicine, Department of Biochemistry, Hatay, Turkey.

We aimed to determine the presence of oxidative stress in rhinitis medicamentosa (RM) and to evaluate the effect of erdosteine (ED) on mucosal changes in a rat model. Twenty-four male rats were used in this experimental study. Three groups were created. Read More

Arerugi 2013 Dec;62(12):1623-30

Yuta Clinic.

Unlabelled: Long-term use of decongestant nasal spray (alpha adrenergic agonist) causes nasal congestion by rhinitis medicamentosa.

Subjects And Methods: We clinically reviewed the cases of 33 patients of rhinitis medicamentosa (23 men, 10 women; mean age, 44.4±15. Read More

Acta Otolaryngol 2014 May 3;134(5):506-12. Epub 2014 Mar 3.

Division of ENT Department, Karolinska Institute, Karolinska University Hospital , Stockholm , Sweden.

Conclusion: Kinetic oscillation stimulation (KOS) of nasal mucosa at low frequency seems to be a possibly effective and safe short-term treatment of non-allergic nasal stuffiness.

Objective: To assess the relief of rhinitis symptoms, especially stuffiness, by comparing active treatment, i.e. Read More

Iran J Public Health 2013 1;42(4):374-9. Epub 2013 Apr 1.

Dept. of Children Diseases N1, Astana Medical University, Astana, Kazakhstan.

Background: The aim was to study the peculiarities of differential diagnosis, prevention and treatment of different forms of rhinitis in Kazakhstan children and adolescents.

Methods: 124 children and adolescents aged 1-17 years were randomly enrolled in our hospital based study in 2010 and 2011. Skin prick tests and total serum IgE level were assessed in all allergic patients. Read More

Am J Rhinol Allergy 2013 May-Jun;27 Suppl 1:S48-51

Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.

Rhinitis is characterized by one or more of the following nasal symptoms: congestion, rhinorrhea (anterior and posterior), sneezing, and itching. It is classified as allergic or nonallergic, the latter being a diverse syndrome that is characterized by symptoms of rhinitis that are not the result of IgE-mediated events. Excluding infectious rhinitis and underlying systemic diseases, clinical entities that can be classified among the disorders that make up the nonallergic rhinitis syndromes include gustatory rhinitis, nonallergic rhinitis with eosinophilia syndrome (NARES), atrophic, drug-induced (rhinitis medicamentosa), hormone induced, senile rhinitis (of the elderly), rhinitis associated with chronic rhinosinusitis with or without nasal polyps, and the idiopathic variant formerly known as vasomotor rhinitis but more accurately denoted as nonallergic rhinopathy (NAR). Read More

Am J Rhinol Allergy 2013 May;27(3):48-51

Rhinitis is characterized by one or more of the following nasal symptoms: congestion, rhinorrhea (anterior and posterior), sneezing, and itching. It is classified as allergic or nonallergic, the latter being a diverse syndrome that is characterized by symptoms of rhinitis that are not the result of IgE-mediated events. Excluding infectious rhinitis and underlying systemic diseases, clinical entities that can be classified among the disorders that make up the nonallergic rhinitis syndromes include gustatory rhinitis, nonallergic rhinitis with eosinophilia syndrome (NARES), atrophic, drug-induced (rhinitis medicamentosa), hormone induced, senile rhinitis (of the elderly), rhinitis associated with chronic rhinosinusitis with or without nasal polyps, and the idiopathic variant formerly known as vasomotor rhinitis but more accurately denoted as nonallergic rhinopathy (NAR). Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2013 Jun 1;130(3):137-44. Epub 2013 Feb 1.

Service d'ORL et de chirurgie cervico-faciale, hôpital Huriez, CHRU de Lille, rue Michel-Polonovski, 59037 Lille cedex, France.

Introduction: Systemic and topical nasal decongestants are widely used in otorhinolaryngology and general practice for the management of acute rhinosinusitis and as an adjuvant in certain forms of chronic rhinosinusitis. These products, very effective to rapidly improve nasal congestion, are sometimes available over the counter and can be the subject of misuse, which is difficult to control. The Société Française d'ORL has recently issued guidelines concerning the use of these decongestants in the doctor's office and the operating room. Read More

Allergy Rhinol (Providence) 2012 21;3(1):e13-5. Epub 2012 Jun 21.

Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, New York, New York.

The diagnosis and treatment of rhinitis, sinusitis, and epistaxis during pregnancy present unique challenges to the otolaryngologist. Poorly controlled sinonasal disease may have significant adverse effects on the mother's quality of life and pregnancy outcomes and the lack of adequately controlled safety data limits the clinician's ability to make informed decisions about management. At the conclusion of this discussion, the reader should be familiar with the available literature and evidence-based guidelines regarding the safety and indications for radiographic imaging, clinical testing, medical intervention, and surgical treatment of sinonasal disease in pregnant patients. Read More

Allergy Asthma Proc 2012 May-Jun;33 Suppl 1:19-21

Nonallergic rhinitis represents a non-IgE-mediated group of disorders that share the symptoms of nasal congestion, rhinorrhea, sneezing, and/or postnasal discharge but not pruritus that characterizes allergic rhinitis. Nonallergic rhinitis may be divided into two broad categories, inflammatory and noninflammatory etiologies. The inflammatory causes include postinfectious (viral and bacterial), rhinitis associated with nasal polyps, and nonallergic rhinitis with eosinophilia, where eosinophils are present in nasal smears but skin testing for aeroallergens is negative. Read More

Kinderkrankenschwester 2011 Oct;30(10):406-8

Immunol Allergy Clin North Am 2011 Aug;31(3):457-67

Brown University, Alpert Medical School, Providence, RI, USA.

It is important to consider a comprehensive differential of possible rhinitis types when considering the diagnosis of chronic rhinitis, including at least 9 subtypes of nonallergic rhinitis: drug-induced rhinitis, gustatory rhinitis, hormonal-induced rhinitis, infectious rhinitis, nonallergic rhinitis with eosinophilia syndrome, occupational rhinitis, senile rhinitis, atrophic rhinitis, and nonallergic rhinopathy. This article focuses on some of the most common types of chronic rhinitis, including mixed rhinitis (allergic and nonallergic overlap), rhinitis medicamentosa, hormonal rhinitis, rhinitis of the elderly, and gustatory rhinitis. Read More

J Allergy Clin Immunol 2011 Apr 5;127(4):927-34. Epub 2011 Mar 5.

Section of Otolaryngology-Head and Neck Surgery, University of Chicago Medical Center, and Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA.

Background: In clinical trials, only about 60% of subjects report an excellent response to intranasal steroids, suggesting a need to add therapies to intranasal steroids to provide additional efficacy.

Objective: To determine whether the combination of fluticasone furoate and oxymetazoline is more efficacious than either agent alone, and to determine whether rhinitis medicamentosa develops after treatment.

Methods: We performed a double-blind, double-dummy, randomized, placebo-controlled parallel study. Read More

Laryngoscope 2010 Oct;120(10):2106-7

Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15219, USA.

Rhinitis medicamentosa occurs with repeated and prolonged use of topical decongestants. The resultant reduced ability to respond to decongestants mediated via enlarged capillary endothelial gaps can lead to profuse bleeding during turbinate surgery. We recommend that patients with rhinitis medicamentosa be weaned off topical decongestants prior to elective turbinate surgery to minimize this complication. Read More