rebound rhinitis

(redirected from chemical rhinitis)

rebound rhinitis

A noninfectious, nonallergic rhinitis caused by rebound vasodilation linked to the use of topical vasoconstricting decongestant sprays for more than 4–6 days.

Clinical findings
Nasal congestion, which responds poorly to increased use of decongestants; patients may snore.

Endoscopy
Nasal mucosa is often beefy-red with punctate bleeding, granular or boggy, with patchy tissue friability and profuse stringy mucoid discharge.
 
DiffDx
Allergic rhinitis, continuous positive airway pressure (CPAP) rhinitis, nasal polyps, non-allergic rhinitis, rhinosinusitis.

Reasons for use of decongestants
Allergy, nonallergic rhinoplasty, chronic rhinosinusitis, nasal polyps, night-time continuous positive airway pressure (CPAP), upper respiratory tract infection.
 
Management
Discontinue decongestants ASAP; oral corticosteroids. 

Pathology
Nasociliary loss, squamous cell metaplasia, epithelial oedema, epithelial cell denudation, goblet cell hyperplasia, increase in epidermal growth factor receptor, inflammation.
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