What Is Rhinitis?
Rhinitis refers to inflammation of the nasal lining, leading to symptoms such as nasal congestion, a runny nose, sneezing and postnasal drip. It is generally categorized into two types: allergic (triggered by the environment) and nonallergic (often triggered by overactive nerves or irritants). Some patients experience features of both.
When left untreated, chronic rhinitis can lead to more serious conditions, such as chronic sinusitis or recurrent ear infections. At the practice of Dr. Pablo Stolovitzky, we specialize in accurate diagnosis and personalized care at our offices in Atlanta (Center Pointe), Decatur and Snellville.
Symptoms of Allergic vs. Nonallergic Rhinitis
While symptoms overlap, there are key differences:
- Allergic Rhinitis: Often includes itchy eyes, nose or throat.
- Nonallergic Rhinitis: Typically presents with congestion and postnasal drip but without the itching sensation familiar to allergies.
Common Triggers for Nonallergic Rhinitis
An abnormal regulation of nasal blood vessels and nerves often causes nonallergic rhinitis. Common triggers include:
- Environmental Irritants: Dust, smoke, strong odors or perfumes.
- Infections: Lingering effects of the cold or flu.
- Medications: Overuse of decongestant sprays (rhinitis medicamentosa) or certain blood pressure medications.
- Physical Factors: Changes in temperature, humidity or even spicy foods.
Medical Management Comes First
Treatment usually begins with medical management tailored to the patient’s symptoms and diagnosis. Options may include:
- Saline Irrigation: To clear irritants and allergens from the nasal passages.
- Intranasal Corticosteroid Sprays: To reduce inflammation of the nasal lining.
- Antihistamines: Oral or nasal, to manage daily symptom flare-ups.
- Anticholinergic Nasal Sprays: To reduce persistent runny nose and drainage.
- Allergy Treatment: Including immunotherapy when allergies are a significant contributor.
Office-Based Treatment for Chronic Rhinitis
For patients whose symptoms remain troublesome despite appropriate medical therapy, office-based treatment targeting the posterior nasal nerves may be considered.
These nerves participate in the regulation of nasal secretions and congestion. Radiofrequency treatment and cryotherapy are two approaches used to modify posterior nasal nerve activity.
Clinical studies demonstrate meaningful improvement in nasal symptoms and quality of life in appropriately selected patients. Some studies of temperature-controlled radiofrequency treatment have reported sustained improvement for up to three years. However, individual outcomes vary, and not every patient will experience the same degree or duration of improvement.
RhinAer® Radiofrequency Treatment
RhinAer® uses temperature-controlled radiofrequency energy to target tissue containing branches of the posterior nasal nerves. The procedure is performed in the office, with no incisions and minimal discomfort for most patients. Dr. Stolovitzky served as the National Principal Investigator for the RhinAer® clinical trial. Learn more about the RhinAer® procedure.
Neuromark® Procedure
For select patients with chronic rhinitis, the Neuromark® procedure is another office-based option that targets the posterior nasal nerves to reduce the abnormal signaling behind persistent congestion and drainage. Downtime is typically minimal, and most patients return to normal activities the same day.
Is Chronic Rhinitis the Cause of Your Symptoms?
An evaluation by an otolaryngologist can help determine whether symptoms are primarily related to chronic rhinitis or whether other conditions, such as chronic sinusitis, septal deviation, turbinate enlargement or nasal valve dysfunction, may be contributing. Identifying the correct cause is the first step toward choosing the right treatment.
Frequently Asked Questions About Chronic Rhinitis
Can chronic rhinitis be cured?
Chronic rhinitis is usually a long-term condition that is managed rather than cured. Many patients achieve good control with medical therapy, and office-based posterior nasal nerve treatment can provide lasting improvement for appropriately selected patients, although results vary from person to person.
How do I know whether my rhinitis is allergic or nonallergic?
Allergic rhinitis is often accompanied by itching of the eyes, nose or throat and tends to follow seasonal or exposure patterns. Nonallergic rhinitis typically causes congestion and drainage without itching. Allergy testing and an examination of the nose help distinguish the two, and some patients have features of both.
What if nasal sprays and antihistamines no longer work?
If symptoms persist despite consistent, correctly used medical therapy, an evaluation can determine whether chronic rhinitis is the primary problem or whether another condition is contributing, and whether an office-based procedure such as RhinAer® may be appropriate.
Expert Care for Complex Nasal Conditions
Dr. Pablo Stolovitzky is a nationally and internationally recognized rhinology expert with decades of experience. His commitment to evidence-based medicine and innovative care ensures that each patient in Metro Atlanta receives the most effective, least invasive treatment possible.
Call Dr. Pablo Stolovitzky for more information or to schedule an appointment.