Rhinitis

Almost 60 million Americans have chronic rhinitis. Rhinitis is a condition that typically involves nasal obstruction or congestion, runny nose, post-nasal drip, itchy nose, and/or sneezing.

There are many causes of these symptoms, although they are broadly divided into two types: allergic rhinitis (symptoms related to allergy) and non-allergic rhinitis (symptoms that are not related to allergy).

What causes Rhinitis?

Allergic rhinitis (also known as hay fever) occurs when your body’s immune system over-reacts to specific, non-infectious particles such as plant pollens, molds, dust mites, animal proteins, chemicals, foods, medicines, insect venom, and other triggers. During an allergic attack, the body releases histamine, and other chemicals, into the mucus membranes of the nose, lungs, and skin. These chemicals cause blood vessels to open which causes swelling. When this happens in the nose, sneezing, itching, runny nose, and congestion can occur.

Allergic rhinitis can be seasonal or year round. Seasonal allergic rhinitis is due to specific plants that are pollenating at that time. Trees in the spring, grasses in the summer, and weeds in the fall. Year round allergies are due to sensitivity to animals, molds, and dust mites.

Non-allergic rhinitis, vasomotor rhinitis, or chronic rhinitis on the other hand, is not due to an allergic reaction. It is due to frequent or longstanding inflammation in the nose caused by:

Side effect of medications (both prescription and over-the-counter)
Eating and drinking
Weather or temperature changes
Aging
Hormonal changes or pregnancy
Consumption of alcohol, especially red wine
Inflammation or irritation in the nose due to a reaction to an environmental irritant (smoke, pollution, chemicals, perfumes, VOCs)
Reflux

Over 24 million Americans suffer from chronic rhinitis. While exact causes may not be known, the nerves in your nose become hyperactive. This results in the nose responding like it is fighting an illness. The nasal linings become congested and mucus production increases which can cause a runny nose or drip down the throat.

What treatment options are available for Rhinitis?

Treating rhinitis depends on the type of rhinitis or specific cause. If there is a specific trigger, then avoidance can be a successful treatment. Often, medications are used to control symptoms. Depending on the specific cause of the rhinitis symptoms, some of the medications that may be used include:

Saline rinses
Antihistamines (oral or nasal sprays)
steroids (either nasal sprays or rinses)
Ipratropium bromide nasal spray

For allergic rhinitis, immunotherapy (allergy shots or drops) may be an option. Ask us if allergen immunotherapy is an option for you.

For severe runny nose or nasal obstruction/congestion that does not respond to medications, office procedures or surgery may be appropriate.

Posterior Nasal Nerve Ablation

For patients that medications do not alleviate their symptoms, posterior nasal nerve ablation is a minimally invasive procedure, aimed at treating the root cause of chronic rhinitis—overactive nerves. Treatment uses either radiofrequency (Rhinaer, Neuromark) or cryotherapy (Clarifix) (cold temperature) to interrupt the signals from these nerves. When these nerves are treated, they no longer tell the nose to drip, run or swell. Due to its limited depth of treatment, the adjacent bone and cartilage are not impacted.

In the office a topical and local anesthetic are given. The device and a small lighted camera (endoscope) are place into the back of your nose. A probe is then applied directly to the area where the nerves are located. In just a few minutes the nerves are treated. You may feel slight pressure, a cooling sensation, or slight discomfort. In general, there is minimal downtime and recovery. You may experience temporary congestion and slight discomfort for a short time after the procedure. Most patients begin to see improvement 2 to 6 weeks after treatment. 4 out of 5 patients report long-lasting improvement.