Document Detail

Traumatic unilateral vasomotor rhinitis.
MedLine Citation:
PMID:  23288805     Owner:  NLM     Status:  In-Data-Review    
Vasomotor rhinitis (VMR) is a commonly encountered entity that may be difficult to diagnose. The classic symptoms are clear rhinorrhea and nasal congestion, commonly brought on by exercise, stress, heat, cold, and environmental irritants. The diagnosis is one of exclusion, and management usually involves avoidance of inciting agents and treatment with an anticholinergic nasal spray. We describe a case of VMR in a 22-year-old woman who presented with symptoms of clear, left-sided rhinorrhea and epiphora that had begun shortly after a motor vehicle accident approximately 1.5 years earlier, but which she had not reported at that time. The patient's left carotid canal had been fractured and the surrounding sympathetic plexus injured in the accident, resulting in an overactive parasympathetic system. Both exercise and heat exacerbated her symptoms. Allergy was excluded by negative allergy testing, and the patient did not respond to fluticasone nasal spray. Given the mechanism of injury, the unilaterality of symptoms, and the patient's lack of response to nasal steroids, it was thought that the VMR was due to the earlier traumatic injury, which had resulted in imbalance of the autonomic neural input. A trial of ipratropium was given to directly treat the parasympathetic overactivity. This treatment resulted in immediate improvement in both the nasal and lacrimal secretions.
Evan J Harlor; J Scott Greene; Catherine Considine
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ear, nose, & throat journal     Volume:  91     ISSN:  1942-7522     ISO Abbreviation:  Ear Nose Throat J     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2013-01-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7701817     Medline TA:  Ear Nose Throat J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E4-6     Citation Subset:  IM    
Department of Otolaryngology, Geisinger Medical Center, 100 North Academy Ave., Danville, PA 17822.
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