| Abstract [eng] |
The widespread use of nasal vasoconstrictors in the 20th century led to the development of a new condition called medicamental rhinitis, also known as rhinitis medicamentosa. Its exact prevalence remains uncertain despite its significant impact on quality of life. Pubmed and The Cochrane Library databases were searched for publications in English or Lithuanian from the last 10 years, available in the Vilnius University network, regarding medicamental or non-allergic rhinitis (n=66). Medicamental rhinitis is a phenotype of non-allergic, non-infectious rhinitis characterized by nasal symptoms, such as nasal obstruction, rhinorrhea and associated problems such as anosmia, xerostomia, sleep disturbances, etc., without signs of upper respiratory tract infection or allergic inflammation. This condition is caused by the use of sympathomimetic amines or imidazoles. A similar condition can be caused by the use of cocaine. While various hypotheses exist regarding the possible development mechanisms of this condition, precise cellular mechanisms remain unclear. Histological examination reveals chronic non-allergic mucosal inflammation, degeneration of the epithelium of the upper respiratory tract mucosa and fibrosis. The diagnosis is based on clinical signs and a detailed medical history. Differential diagnosis is also important to exclude other possible causes of nasal congestion. Treatment usually starts with discontinuing topical decongestants. If necessary, alternative treatment with intranasal corticosteroids or antihistamines is given instead. Surgical approaches such as turbinoplasty may also be considered. Rhinitis medicamentosa is a preventable condition, therefore education of patients and healthcare professionals, as well as the involvement of pharmacists, is important to effectively prevent the condition. |
