Autonomic Nervous System Evaluation of Patients With Vasomotor Rhinitis

TLDR

Vasomotor rhinitis is thought to arise from parasympathetic hyperactivity or autonomic imbalance, yet its precise relationship remains unclear, and recent autonomic laboratory batteries now enable testing of such dysfunction, including potential triggers like nasal trauma and reflux. The study aims to demonstrate quantitative autonomic testing and apply it to investigate the relationship between chronic vasomotor rhinitis and autonomic dysfunction. The authors performed autonomic testing on 19 vasomotor rhinitis patients and compared results with 75 sex‑ and age‑matched controls. Patients exhibited significant sudomotor, cardiovagal, and adrenergic abnormalities, with a composite autonomic score of 2.43 versus 0.11 in controls (P < .005), indicating marked autonomic dysfunction.

Abstract

Abstract Objective To demonstrate the utility of quantitative neurological laboratory testing of autonomic nervous system dysfunction and to apply this methodology to further study the relation of chronic vasomotor (nonallergic) rhinitis to the autonomic nervous system. Methods It has been suspected that vasomotor rhinitis is due either to a hyperactive parasympathetic nervous system or an imbalance between it and the sympathetic nervous system. The exact relation has not been determined. Recently neurological laboratories have been developed in which a battery of tests can be performed to determine reactivity of the autonomic nervous system. Results Autonomic nervous system testing was performed on 19 patients with symptoms fulfilling the diagnostic criteria for vasomotor rhinitis and the results were compared with 75 sex‐ and age‐matched control subjects. Patients with vasomotor rhinitis had significant abnormalities of their sudomotor, cardiovagal, and adrenergic subscores. Their composite autonomic scale score was significantly impaired at 2.43, as compared with 0.11 for controls ( P &lt; .005). Conclusion Autonomic nervous system dysfunction is significant in patients with vasomotor rhinitis. Possible factors that trigger this dysfunction including nasal trauma and extraesophageal manifestations of gastroesophageal reflux are discussed.