Nonallergic Rhinitis

Abstract

Non-allergic rhinitis (NAR) is a heterogeneous nasal disease with high global prevalence. While the specific factors contributing to the origin of NAR remain uncertain, there is indication that neurogenic factors play a significant role in the development of NAR. There are seven subtypes with overlapping presentations, including senile or geriatric rhinitis, gustatory rhinitis, drug-induced rhinitis, hormonal rhinitis, smokers’ rhinitis, occupational rhinitis and idiopathic rhinitis. The approach to treatment is focused on alleviating symptoms and parallels the methods used for allergic rhinitis. Patients are advised to minimize exposure to identified triggers whenever feasible. Initial treatments involve the use of primary interventions such as intranasal corticosteroids, intranasal antihistamines, and intranasal ipratropium. Combination therapies may be considered if single interventions do not effectively manage symptoms. The surgery is considered in patients refractory to medical therapy, the reduction of inferior turbinate hypertrophy is a surgical procedure with an excellent outcome, besides the selective neurectomy of the vidian branches, has also proven to be effective.