Objective: To evaluate the efficacy and safety of posterior nasal neurectomy on the treatment of nasal congestion, rhinorrhea, sneezing, and post-nasal discharge in intractable rhinitis patients. Methods: Design: Preliminary case series. Setting: Tertiary University Medical Center. Participant: Ten (10) patients with intractable rhinitis underwent endoscopic posterior nasal neurectomy in both sides. Symptoms were compared pre- and post-operatively one month and one year after surgery using Visual Analog Scale (VAS) scores. Endoscopic pre- and one-month post-operative Lund-Mackay scores were also compared. Results: All four mean nasal symptom scores were reduced significantly at 1-month follow-up for nasal congestion (1.5 ± 1.08 vs 4.1 ± 0.5687, p = .00001), rhinorrhea (0.7 ± 0.823 vs 3.4 ± 0.966, p = .00001) post-nasal discharge (0.9 ± 0.994 vs 2.4 ± 1.5, p = .03), and sneezing (1.1 ± 0.738 vs 3 ± 0.943, p = .02). Mean endoscopic scores were also reduced significantly at one month, from 12.9 ± 2.55 to 4.2 ± 3, p = 0.0001.In the 6 patients that followed up at 1-year, post-operative mean nasal symptoms were still significantly better for congestion (0.6667 ± 0.8165 vs 4 ± 0.632, p = 0.00001), rhinorrhea (0.6667 ± 0.5164 vs 3.67 ± 1.033, p = .001), post-nasal discharge (0.1667 ± 0.40825 vs 2.17 ± 1.835, p = .033), sneezing (0.5 ± 0.54772 vs 3.17 ± 0.983, p = 0.0001). Mean post-operative VAS nasal scores and endoscopic scores were well associated (Correlation Coefficient -.648, p = .048). Conclusion Posterior nasal neurectomy could be considered as a safety and effective way to treat intractable rhinitis patients in Vietnam.
Rhinitis, Vasomotor

Humans ; Rhinitis, Vasomotor ; physiopathology

Humans ; Denervation ; Rhinitis, Vasomotor ; Endoscopy

Background & Objectives: Vasomotor rhinitis (VMR) is a chronic non-allergic rhinitis without the increased Ig E level and eosinophilia. Azelastine hydrochloride is a second generation anti-histamine medication with anti-inflammatory properties that inhibits the synthesis of inflammatory materials. There are reports that azelastine hydrochloride can be effective in the treatment of VMR. Therefore, this study examined the clinical efficacy of intranasal azelastine hydrochloride spray in comparison with placebo for the treatment of VMR. MATERIALS AND METHOD: This study was a prospective double blind randomized test. The subjects consisted of 84 VMR patients. Among them, 54 patients were treated with intranasal azelastine hydrochloride for 4 weeks and 30 patients with intranasal normal saline. Following the treatment, an analysis of the symptom score was performed in order to compare the treatment effects between the study group and the control group. RESULTS: In the study group, the symptom score was significantly improved in the areas of sneezing (1.38 to 0.72), rhinorrhea (1.57 to 0.76), nasal obstruction (1.76 to 1.01) and postnasal drip (1.43 to 0.65). In the control group, however, the symptom score was significantly improved in a single area of rhinorrhea (1.73 to 0.65). Patients in the study group, thus, displayed greater improvements in the areas of sneezing, rhinorrhea, nasal obasturction and postnasal drip comparative to the control group. Consequently, the study group patients were more satisfied with their quality of life than those of the control group. CONCLUSION: Azelastine chloride is a useful medicine for the treatment of VMR, especially in controlling sneezing, rhinorrhea, nasal obstruction and postnasal drip.
Eosinophilia ; Humans ; Nasal Obstruction ; Prospective Studies ; Quality of Life ; Rhinitis ; Rhinitis, Vasomotor* ; Sneezing

BACKGROUND AND OBJECTIVES: A recently proposed apparatus for the treatment of nasal inflammatory affections is the atomized nasal douche. The aim of the paper was to assess the efficacy of the atomized nasal douche in patients affected by acute or chronic rhinopathy. MATERIALS AND METHODS: We selected 60 adult patients: They were subdivided into two groups and each group consisted of 15 patients suffering from vasomotor rhinitis and 15 patients affected by acute rhinitis. The former underwent atomized nasal douche and the latter underwent nasal lavages with saline solution. We performed bacterial cultures of the nasal swab and the secretions drawn from the nasal cavity, a rhinomanometric test, an assessment of the symptomatologic score before and after the treatment in all the patients. RESULTS: At the end of treatment, there was a reduction or complete disappearance of the bacterial colonies in 23 of the 30 patients treated with the atomized nasal douche, while in the control group the same result occurred in only 10 of the 30 patients. CONCLUSION: Our results confirm that the atomized nasal douche performs an efficacious lavage of the nasal cavity, representing a good support for the treatment of inflammatory processes of the nose.
Adult ; Humans ; Nasal Cavity ; Nasal Lavage ; Nose ; Rhinitis ; Rhinitis, Vasomotor ; Sodium Chloride ; Therapeutic Irrigation

BACKGROUND AND OBJECTIVES: A recently proposed apparatus for the treatment of nasal inflammatory affections is the atomized nasal douche. The aim of the paper was to assess the efficacy of the atomized nasal douche in patients affected by acute or chronic rhinopathy. MATERIALS AND METHODS: We selected 60 adult patients: They were subdivided into two groups and each group consisted of 15 patients suffering from vasomotor rhinitis and 15 patients affected by acute rhinitis. The former underwent atomized nasal douche and the latter underwent nasal lavages with saline solution. We performed bacterial cultures of the nasal swab and the secretions drawn from the nasal cavity, a rhinomanometric test, an assessment of the symptomatologic score before and after the treatment in all the patients. RESULTS: At the end of treatment, there was a reduction or complete disappearance of the bacterial colonies in 23 of the 30 patients treated with the atomized nasal douche, while in the control group the same result occurred in only 10 of the 30 patients. CONCLUSION: Our results confirm that the atomized nasal douche performs an efficacious lavage of the nasal cavity, representing a good support for the treatment of inflammatory processes of the nose.
Adult ; Humans ; Nasal Cavity ; Nasal Lavage ; Nose ; Rhinitis ; Rhinitis, Vasomotor ; Sodium Chloride ; Therapeutic Irrigation

BACKGROUND AND OBJECTIVES: Laser vaporization on the inferior turbinate can be an valuable surgical method with safety, less morbidity and good efficacy. However, long term results are not exactly known. Furthermore, concrete data for success rates using different laser techniques is not available yet. The aim of this study is to evaluate the long-term result of laser surgery using different laser technique in patients with hypersensitive nasal diseases. SUBJECTS AND METHOD: We retrospectively reviewed 53 cases which had been treated with CO2 laser and followed up for more than 3 years. The subjects consisted of 29 patients with allergic rhinitis and 24 patients with vasomotor rhinitis. Laser surgical techniques were divided into two groups;vaporization of only inferior turbinate (conventional group) and inferior turbinate, upper septum, middle turbinate, agger nasi (extended group). Changes in the degree of nasal obstruction, watery rhinorrhea, sneezing were compared postoperatively between the two surgical procedure, and two different diseases. RESULTS: Long-term result (67%) was slightly lower than short-term result (69%). There was no difference in the success rates (68%) for both laser and surgical technique. Patients with vasomotor rhinitis (75%) showed better success rate than with allergic rhinitis (62%). Rate of success was better in the extended group than in the conventional group for watery rhinorrhea and sneezing. CONCLUSION: Success rate of laser surgery performed at Inha university hospital was 68%. The extended technique was more effective than the conventional technique for short-term result. However, there was no difference in the long-term results using different laser techniques.
Humans ; Laser Therapy* ; Lasers, Gas ; Nasal Obstruction ; Nose Diseases ; Retrospective Studies ; Rhinitis ; Rhinitis, Vasomotor ; Sneezing ; Turbinates

Local allergic rhinitis is defined as a localized allergic reaction of the nasal mucosa in the absence of systemic atopy. Its main pathophysiological mechanism can be summarized as: 1) increased specific immunoglobulin E in the nasal fluid, and 2) Th2 allergic mechanism localized in the nasal mucosa. In patients whose result of a skin prick test is totally negative for all antigens, practitioners could diagnose local allergic rhinitis using a nasal provocation test. Oral antihistamines and intranasal steroids can be an effective treatment. Subcutaneous immunotherapy can also be helpful. Further study is essential to further elucidate the detailed pathophysiologic mechanism and set up global standard diagnostic criteria.
Histamine Antagonists ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Immunotherapy ; Nasal Mucosa ; Nasal Provocation Tests ; Rhinitis, Allergic* ; Rhinitis, Vasomotor ; Skin ; Steroids

OBJECTIVETo evaluate the efficacy of endoscopic vidian neurectomy in the management of moderate-severe persistent allergic rhinitis, and to explore its possible mechanism.

METHODSOne hundred and ninety-one patients with moderate-severe persistent allergic rhinitis were divided into three groups: endoscopic vidian neurectomy was carried out in 71 patients (group A), partial inferior turbinectomy and/or septal-plasty in 39 patients (group B), and 81 patients were as control (group C). The life quality was assessed at 6 month, 1 year and 3 years after operation using rhinoconjunctivitis quality of life questionnaire (RQLQ) and visual analogue scale (VAS).

RESULTSAmong 191 cases, one hundred and forty-five cases had complete follow-up documents. The average score of RQLQ and VAS score (x(-) ± s) were significantly decreased at the time of 6 months (0.84 ± 0.41, 2.55 ± 1.57), 1 year (0.91 ± 0.43, 2.63 ± 1.71) and 3 years (1.03 ± 0.46, 2.81 ± 1.75) after endoscopic vidian neurectomy than scores before operation (2.25 ± 0.49, 7.34 ± 1.11), F = 115.45, 133.09, respectively, P < 0.001, and also significantly lower than scores in patients in group B or control group at the same period after treatment. By patient's self-evaluation, the ratio of greatly-improved, improved and not-improved was respectively, 65.5% (38 cases), 24.1% (14 cases), 10.4% (6 cases), and significantly higher in patients in group A than in patients in group B (U = 237.0, P < 0.001) and group C (U = 246.0, P < 0.001). There was no severe complication in all patients observed.

CONCLUSIONEndoscopic vidian neurectomy is an effective and safe technique in the management of moderate-severe persistent allergic rhinitis.

Adult ; Denervation ; methods ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic, Perennial ; surgery ; Rhinitis, Vasomotor ; surgery ; Treatment Outcome

BACKGROUND AND OBJECTIVES: Although eosinophilic nonallergic rhinitis (ENR) is a well recognized entity, its clinical features and the response to the treatment have not been definitively elucidated. Authors aimed to investigate the clinical characteristics of ENR and the response to the nasal steroids. MATERIALS AND METHOD: A prospective study was conducted for 59 patients diagnosed as ENR at the department of Center between 1994 and 2001. Diagnostic criteria include rhinitis symptoms lasting more than 3 months, nasal eosinophilia, and negative results for allergic skin test or MAST. Patients were treated with nasal steroids for three weeks and compared the pre-treatment and post-treatment symptom scores. RESULTS: Of 59 patients, 25 were males and 34 females. Their age ranged from 6 to 67 years (average : 35 years). Nasal obstruction was most frequently complained by the patients, followed by rhinorrhea, and sneezing. The percentage of nasal secretion eosinophils ranged from 10 to 100% with a mean of 71%. Treatment with topical steroids was effective in 53 patients (90%) to relieve symptoms. CONCLUSION: Unlike allergic rhinitis, ENR commonly develops in the adults with an average age of 31 years. Topical steroid is effective in 90% of patients to relieve rhinitic symptoms. Differential diagnosis of chronic rhinitis using allergic skin test and nasal secretion eosinophils is needed for the adequate treatment.
Adult ; Diagnosis, Differential ; Eosinophilia ; Eosinophils* ; Female ; Humans ; Male ; Nasal Obstruction ; Prospective Studies ; Rhinitis* ; Rhinitis, Vasomotor ; Skin Tests ; Sneezing ; Steroids*