Chronic Rhinitis

Chronic rhinitis is a recurrent nasal blockage/discharge that doesn’t resolve on its own, and symptoms arise from the constant irritation or inflammation of the inner lining of the nose. When the nasal linings become inflamed, it causes nasal congestion and mucus production increases resulting in a runny nose and post-nasal drip (mucus in the throat). Post-nasal drip is one of the most common characteristics of chronic rhinitis, and over a prolonged period of time, it may lead to a chronic sore throat, a chronic cough, or throat clearing.

How Does Chronic Rhinitis Affect the Nasal Cavity?

Within a normal nasal cavity, the nasal nerves help regulate the nasal activity, turbinates warm and moisturize air as it flows through the nose, and normal mucus production helps protect against infectious agents.

Normal Nasal Cavity

With chronic rhinitis, the nasal nerves send too many signals, inflamed turbinates contribute to congestion and stuffy nose, and excessive mucus can drip down the throat and cause a runny nose.

Chronic Rhinitis Nasal Cavity

What are Symptoms of Chronic Rhinitis?

Symptoms of chronic rhinitis usually include:

  • Congestion
  • Mouth breathing
  • Sinus pressure
  • Sinus infections
  • Runny nose
  • Postnasal drip
  • Chronic cough
  • Sore throat

What Causes Chronic Rhinitis?

Rhinitis has many possible causes and is categorized into three areas including:

  • Allergic Rhinitis
  • Non-Allergic or Vasomotor Rhinitis
  • Mixed Rhinitis (a combination of allergic and non-allergic)

What is Allergic Rhinitis?

With allergic rhinitis (hay fever) symptoms often occur due to an allergic reaction to an allergen. The most common allergens include seasonal pollens (from trees, grasses, and weeds), as well as perennial indoor allergens, such as dust mites, pet dander, and some molds. Other allergens may include some workplace irritants. Food is not a common cause of allergic rhinitis in adults, but certain foods may cause nasal symptoms in some young children.

Symptoms generally include sneezing, runny nose, nasal congestion and itching of the nose and throat. Nasal discharge is usually clear and watery. If you only have symptoms at certain times of the year, you most likely have allergic rhinitis. However, if the allergen is pet dander or house dust, you would have symptoms year-round, which is referred to as perennial allergic rhinitis.

Treatment for allergic rhinitis usually includes allergy medicine or immunotherapy (allergy shots).

What is Non-Allergic Rhinitis?

Non-allergic rhinitis is a medical term used to describe individuals who have symptoms similar to nasal allergies but don’t have any identifiable cause for it. People who have non-allergic rhinitis do not respond to allergy treatments and allergy testing is negative. Unlike allergic rhinitis, non-allergic rhinitis doesn’t involve the immune system. And non-allergic rhinitis rarely causes an itchy nose, eyes or throat as the allergic form does.

Vasomotor rhinitis is associated with changes in the central nervous system’s control of the blood vessels in the nose. This overactive nerve in the nose stimulates the lining of the nose to become congested, runny, and have postnasal drip. As a result, people are more sensitive to various factors including changes in humidity or exposure to chemicals (i.e., fumes, smoke, drafts or wind).

What Else Can Cause Rhinitis?

Other causes of chronic rhinitis may include nasal obstructions, such as a deviated septum, a nasal polyp, or a foreign body (particularly in children), which can lead to congestion. Sinus infections may also lead to nasal congestion and produce a colored nasal discharge.

How is Chronic Rhinitis Diagnosed?

The diagnosis of chronic rhinitis is based largely on symptomatic criteria. Your ENT (ear, nose, and throat) doctor will ask you questions about your symptoms and will examine your nose.

As part of your initial assessment, your doctor may order a sinus x-ray to see if a sinus infection is present. Allergy skin testing may also be done to determine if certain allergens are triggering some or all of your nasal symptoms.

How is Chronic Rhinitis Treated?

To treat your chronic rhinitis, your doctor may prescribe medications such as nasal antihistamines, nasal corticosteroids, or oral antihistamines to help alleviate your symptoms. There are also some home remedies like nasal irrigation that can help, as well as some over-the-counter nasal decongestant sprays.

If you have specific triggers that cause your symptoms, your doctor may advise you to avoid those triggers–things such as wood-burning stoves and fireplaces, cleaning agents and household sprays, perfumes, and scented products. Additionally, you may be advised to quit smoking or not to be around people who smoke, especially if this is one of your triggers.

If you don’t respond to medical management of your symptoms, your doctor may prescribe ClariFix treatment (this treatment is only available by prescription).

What is ClariFix?

ClariFix is an FDA-cleared medical device used for treating chronic rhinitis in adults. ClariFix cryotherapy uses breakthrough cooling technology to target the inflamed nasal tissue and the underlying nerves, cooling them to freezing temperatures to reduce nerve signals and improve nasal symptoms. This treatment provides long-term chronic rhinitis symptom relief, reducing symptoms of a runny nose and congestion.

ClariFix FAQs

After treatment, patients are advised to use saline irrigation for 3 weeks to help with temporary congestion.

ClariFix treatment provides a longer lasting solution as it targets your nasal nerves that may be out of balance, causing your nasal symptoms. In interrupting the pathways of nasal nerves, ClariFix treatment reduces your symptoms associated with chronic rhinitis.

In a clinical study, 4 out of 5 people reported long-lasting improvement with the ClariFix device, including a reduction in symptoms of a runny nose and congestion. Chronic rhinitis symptoms improved by 56% at 90 days and improvement was maintained at 1 year.

During the procedure, your doctor places the ClariFix balloon inside the nose (under endoscopic guidance) on the nerve that causes the chronic rhinitis and it is rapidly cooled using nitrogen gas.

Yes, ClariFix can be done in your doctor’s office under local anesthesia.

Most patients tolerate treatment very well. In a study of 27 patients, the cryotherapy was well-tolerated and patients reported an average pain rating of 1.19 on the Wong-Baker FACES pain scale (0 = minimum score, 5 = maximum score).

With any cryosurgery procedure, there are some side effects, but those associated with the nasal passageway include, pain/discomfort, headache, facial pain, bleeding, dry nose, and ear blockage. These symptoms usually resolve on their own immediately after treatment or within a week or two after treatment.

Most patients begin to see improvement between 7 days and 30 days post-treatment.

There is minimal downtime for recovery from this treatment. Most patients can return to normal activities the next day.

ClariFix is safe. In a clinical study, the ClariFix device was found to be well-tolerated with no device or procedure-related serious adverse events.

The ClariFix device uses a special cooling probe to freeze a small area of nasal tissue in the back of the nose. The cooling time takes just a few minutes, and patients can go home within 30 minutes after the procedure.

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If you are interested in treatment for chronic rhinitis, contact North Dallas ENT at (214) 382-5100 to set up a consultation.