Vasomotor Rhinitis following Trauma to the Nose

Abstract

Complaints of nasal obstruction following nasal trauma without any deformation have been noticed by rhinologists for many years. However, neither an epidemiologic nor a pathophysiologic connection has ever been established. The complaints and physical examination findings of these patients resemble those of vasomotor rhinitis. Only very few articles suggesting nasal trauma as a possible cause for vasomotor rhinitis have ever been published. We present a retrospective study that found 87 of 802 patients to suffer from vasomotor rhinitis following nasal trauma. No other factors known to cause vasomotor rhinitis were present in these patients. None had any previous nasal problems. We therefore suggest that nasal trauma was the causative factor in their vasomotor rhinitis.

Vasomotor Rhinitis Is Not a Wastebasket Diagnosis

“…15 Trauma has been implicated in the development of vasomotor rhinitis through 2 possible mechanisms. 11 One is through direct stimulation of the parasympathetic nerve endings in the nasal mucosa, which is a result of the anatomic changes in the nasal tissues produced by the trauma. 11 Beekhuis, 16 who reports vasomotor rhinitis in 10% of postrhinoplasty patients, believes that it is a result of autonomic changes in the turbinate tissue as a result of the surgical trauma.…”

“…11 One is through direct stimulation of the parasympathetic nerve endings in the nasal mucosa, which is a result of the anatomic changes in the nasal tissues produced by the trauma. 11 Beekhuis, 16 who reports vasomotor rhinitis in 10% of postrhinoplasty patients, believes that it is a result of autonomic changes in the turbinate tissue as a result of the surgical trauma. Local reflexes are thought to be disturbed by trauma, resulting in neuropeptide release and adverse tissue response.…”

Rinite vasomotora pós-cirúrgica: diagnóstico diferencial de rinoliquorréia

“…A tomografia computadorizada de seios da face com injeção de contraste liquórico pode demonstrar o local da fístula em 46 a 81% dos casos 6,12 . Neste caso, a tomografia realizada não evidenciou uma fístula, o que não excluiu o diagnóstico.…”

“…Há poucos casos de rinite vasomotora relacionados com trauma cirúrgico relatados na literatura. Segal et al (1999) demonstraram uma diferença estatisticamente significativa na freqüência de rinite vasomotora entre pacientes que apresentaram traumas nasais e controles 12 . Beekhuis (1976) relatou a ocorrência de 10% de rinite vasomotora em pacientes submetidos a rinoplastia 14 .…”

Vasomotor Rhinitis

“…The authors concluded that the sympathetic nervous system is hypoactive or that there is an imbalance between the parasympathetic and sympathetic system rather than a hyperactive parasympathetic system. Nasal trauma has been mentioned as a possible triggering factor for this autonomic dysfunction [40]. Midfacial pain syndrome has many features resembling tension-type headaches.…”