Skip to main content
SpringerLink
Log in
Book cover

All Around the Nose pp 353–363Cite as

Nonallergic Rhinitis

  • Chapter
  • First Online:

  • 184 Accesses

Abstract

Rhinitis is defined as the inflammation of the nose. Its major symptoms are nasal congestion, rhinorrhea and sneezing. It is a common clinical disorder that causes substantial morbidity universally. It is well known that it has a negative influence on life quality, and functioning at the office and the classrooms. Although rhinitis is a universal disease, it is associated with many controversies, including its definitions, classifications, and terminology. Since there is high variability in both underlying pathophysiologic mechanisms (endotypes) and clinical presentations (phenotypes) of rhinitis, no clear guidelines for its diagnosis and treatment have been established. Even the term “rhinitis” is controversial since it implies inflammation; however, some rhinitis phenotypes seem to lack an inflammatory component. Nonallergic rhinitis is a heterogeneous collection of nasal conditions characterized by symptoms like rhinorrhea, nasal congestion, sneezing, and postnasal drainage not related to IgE-mediated events. The practicing otolaryngologist should take into account a broad differential of potential rhinitis types whilst bearing in mind the diagnosis of chronic rhinitis, along with the following subtypes of nonallergic rhinitis which include nonallergic rhinopathy, formerly referred to as vasomotor rhinitis or idiopathic rhinitis, nonallergic rhinitis with eosinophilia syndrome (NARES), drug-induced rhinitis, hormonal-induced rhinitis, atrophic rhinitis, senile rhinitis, gustatory rhinitis, and chronic rhinosinusitis. This chapter focuses on the poorly comprehended condition called nonallergic rhinitis and helps the reader on determining the pathophysiology, differential diagnosis, and treatment of its subtypes.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Papadopoulos NG, Bernstein JA, Demoly P, Dykewicz M, Fokkens W, Hellings PW, Peters AT, Rondon C, Togias A, Cox LS. Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report. Allergy. 2015;70(5):474–94.

    Article  CAS  PubMed  Google Scholar 

  2. Mastin T. Recognizing and treating non-infectious rhinitis. J Am Acad Nurse Pract. 2003;15(9):398–409.

    Article  PubMed  Google Scholar 

  3. Kim YH, Oh YS, Kim KJ, Jang TY. Use of cold dry air provocation with acoustic rhinometry in detecting nonspecific nasal hyperreactivity. Am J Rhinol Allergy. 2010;24(4):260–2.

    Article  PubMed  Google Scholar 

  4. Papadopoulos NG, Guibas GV. Rhinitis subtypes, endotypes, and definitions. Immunol Allergy Clin N Am. 2016;36(2):215–33.

    Article  Google Scholar 

  5. Kaliner MA. Nonallergic rhinopathy (formerly known as vasomotor rhinitis). Immunol Allergy Clin N Am. 2011;31(3):441–55.

    Article  Google Scholar 

  6. Settipane RA, Charnock DR. Epidemiology of rhinitis: allergic and nonallergic. Clin Allergy Immunol. 2007;19:23–34.

    PubMed  Google Scholar 

  7. Bousquet J, Fokkens W, Burney P, Durham SR, Bachert C, Akdis CA, Canonica GW, Dahlen SE, Zuberbier T, Bieber T, Bonini S, Bousquet PJ, Brozek JL, Cardell LO, Crameri R, Custovic A, Demoly P, van Wijk RG, Gjomarkaj M, Holland C, Howarth P, Humbert M, Johnston SL, Kauffmann F, Kowalski ML, Lambrecht B, Lehmann S, Leynaert B, Lodrup-Carlsen K, Mullol J, Niggemann B, Nizankowska-Mogilnicka E, Papadopoulos N, Passalacqua G, Schünemann HJ, Simon HU, Todo-Bom A, Toskala E, Valenta R, Wickman M, Zock JP. Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2LEN paper. Allergy. 2008;63(7):842–53.

    Article  CAS  PubMed  Google Scholar 

  8. Settipane RA. Epidemiology of vasomotor rhinitis. World Allergy Organ J. 2009;2(6):115–8.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kaliner MA. Azelastine and olopatadine in the treatment of allergic rhinitis. Ann Allergy Asthma Immunol. 2009;103(5):373–80.

    Article  CAS  PubMed  Google Scholar 

  10. Kaliner MA, Baraniuk JN, Benninger MS, Bernstein JA, Lieberman P, Meltzer EO, Naclerio RM, Settipane RA, Farrar JR. Consensus description of inclusion and exclusion criteria for clinical studies of nonallergic rhinopathy (NAR), previously referred to as vasomotor rhinitis (VMR), nonallergic rhinitis, and/or idiopathic rhinitis. World Allergy Organ J. 2009;2(8):180–4.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Baroody FM. Nonallergic rhinitis: mechanism of action. Immunol Allergy Clin N Am. 2016;36(2):279–87.

    Article  Google Scholar 

  12. Macpherson LJ, Dubin AE, Evans MJ, Marr F, Schultz PG, Cravatt BF, Patapoutian A. Noxious compounds activate TRPA1 ion channels through covalent modification of cysteines. Nature. 2007;445(7127):541–5.

    Article  CAS  PubMed  Google Scholar 

  13. Van Gerven L, Alpizar YA, Wouters MM, Hox V, Hauben E, Jorissen M, Boeckxstaens G, Talavera K, Hellings PW. Capsaicin treatment reduces nasal hyperreactivity and transient receptor potential cation channel subfamily V receptor 1 (TRPV1) overexpression in patients with idiopathic rhinitis. J Allergy Clin Immunol. 2014;133(5):1332–9, 1339.e1-3.

    Article  PubMed  CAS  Google Scholar 

  14. Murdoch RD, Bareille P, Denyer J, Newlands A, Bentley J, Smart K, Yarnall K, Patel D. TRPV1 inhibition does not prevent cold dry air-elicited symptoms in non-allergic rhinitis. Int J Clin Pharmacol Ther. 2014;52(4):267–76.

    Article  CAS  PubMed  Google Scholar 

  15. Holland C, van Drunen C, Denyer J, Smart K, Segboer C, Terreehorst I, Newlands A, Beerahee M, Fokkens W, Tsitoura DC. Inhibition of capsaicin-driven nasal hyper-reactivity by SB-705498, a TRPV1 antagonist. Br J Clin Pharmacol. 2014;77(5):777–88.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Bernstein JA, Davis BP, Picard JK, Cooper JP, Zheng S, Levin LS. A randomized, double-blind, parallel trial comparing capsaicin nasal spray with placebo in subjects with a significant component of nonallergic rhinitis. Ann Allergy Asthma Immunol. 2011;107(2):171–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Joe SA. Nonallergic rhinitis. Facial Plast Surg Clin North Am. 2012;20(1):21–30.

    Article  PubMed  Google Scholar 

  18. Scarupa MD, Kaliner MA. Nonallergic rhinitis, with a focus on vasomotor rhinitis: clinical importance, differential diagnosis, and effective treatment recommendations. World Allergy Organ J. 2009;2(3):20–5.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Settipane RA. Other causes of rhinitis: mixed rhinitis, rhinitis medicamentosa, hormonal rhinitis, rhinitis of the elderly, and gustatory rhinitis. Immunol Allergy Clin N Am. 2011;31(3):457–67.

    Article  Google Scholar 

  20. Greiwe J, Bernstein JA. Nonallergic rhinitis: diagnosis. Immunol Allergy Clin N Am. 2016;36(2):289–303.

    Article  Google Scholar 

  21. Stankiewicz JA, Chow JM. Nasal endoscopy and the definition and diagnosis of chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2002;126(6):623–7.

    Article  PubMed  Google Scholar 

  22. Philip G, Togias AG. Nonallergic rhinitis. Pathophysiology and models for study. Eur Arch Otorhinolaryngol. 1995;252(Suppl 1):S27–32.

    Article  PubMed  Google Scholar 

  23. Van Gerven L, Boeckxstaens G, Jorissen M, Fokkens W, Hellings PW. Short-time cold dry air exposure: a useful diagnostic tool for nasal hyperresponsiveness. Laryngoscope. 2012;122(12):2615–20.

    Article  PubMed  Google Scholar 

  24. Segboer CL, Holland CT, Reinartz SM, Terreehorst I, Gevorgyan A, Hellings PW, van Drunen CM, Fokkens WJ. Nasal hyper-reactivity is a common feature in both allergic and nonallergic rhinitis. Allergy. 2013;68(11):1427–34.

    Article  CAS  PubMed  Google Scholar 

  25. Meltzer EO. The treatment of vasomotor rhinitis with intranasal corticosteroids. World Allergy Organ J. 2009;2(8):166–79.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Scadding GK, Lund VJ, Jacques LA, et al. A placebo-controlled study of fluticasone propionate aqueous nasal spray and beclomethasone dipropionate in perennial rhinitis: efficacy in allergic and non-allergic perennial rhinitis. Clin Exp Allergy. 1995;25:737.

    Article  CAS  PubMed  Google Scholar 

  27. Webb DR, Meltzer EO, Finn AF Jr, Rickard KA, Pepsin PJ, Westlund R, Cook CK. Intranasal fluticasone propionate is effective for perennial nonallergic rhinitis with or without eosinophilia. Ann Allergy Asthma Immunol. 2002;88(4):385–90.

    Article  CAS  PubMed  Google Scholar 

  28. Daramola OO, Kern RC. An update regarding the treatment of nonallergic rhinitis. Curr Opin Otolaryngol Head Neck Surg. 2016;24(1):10–4.

    Article  PubMed  Google Scholar 

  29. Kirtsreesakul V, Hararuk K, Leelapong J, Ruttanaphol S. Clinical efficacy of nasal steroids on nonallergic rhinitis and the associated inflammatory cell phenotypes. Am J Rhinol Allergy. 2015;29(5):343–9.

    Article  PubMed  Google Scholar 

  30. Jacobs R, Lieberman P, Kent E, Silvey M, Locantore N, Philpot EE. Weather/temperature-sensitive vasomotor rhinitis may be refractory to intranasal corticosteroid treatment. Allergy Asthma Proc. 2009;30(2):120–7.

    Article  CAS  PubMed  Google Scholar 

  31. Banov CH, Lieberman P, Vasomotor Rhinitis Study Groups. Efficacy of azelastine nasal spray in the treatment of vasomotor (perennial nonallergic) rhinitis. Ann Allergy Asthma Immunol. 2001;86(1):28–35.

    Article  CAS  PubMed  Google Scholar 

  32. Howland WC, Amar NJ, Wheeler W, Sacks H. Efficacy and safety of azelastine 0.15% nasal spray administered once daily in patients with allergy to Texas mountain cedar pollen. Int Forum Allergy Rhinol. 2011;1(4):275–9.

    Article  PubMed  Google Scholar 

  33. Lieberman PL, Smith P. Nonallergic rhinitis: treatment. Immunol Allergy Clin N Am. 2016;36(2):305–19.

    Article  Google Scholar 

  34. Lieberman P, Kaliner MA, Wheeler WJ. Open-label evaluation of azelastine nasal spray in patients with seasonal allergic rhinitis and nonallergic vasomotor rhinitis. Curr Med Res Opin. 2005;21(4):611–8.

    Article  CAS  PubMed  Google Scholar 

  35. Kaliner MA. A novel and effective approach to treating rhinitis with nasal antihistamines. Ann Allergy Asthma Immunol. 2007;99(5):383–90.

    Article  PubMed  Google Scholar 

  36. Singh U, Bernstein JA, Haar L, Luther K, Jones WK. Azelastine desensitization of transient receptor potential vanilloid 1: a potential mechanism explaining its therapeutic effect in nonallergic rhinitis. Am J Rhinol Allergy. 2014;28(3):215–24.

    Article  PubMed  Google Scholar 

  37. Kaliner MA, Oppenheimer J, Farrar JR. Comprehensive review of olopatadine: the molecule and its clinical entities. Allergy Asthma Proc. 2010;31(2):112–9.

    CAS  PubMed  Google Scholar 

  38. Lieberman P, Meltzer EO, LaForce CF, Darter AL, Tort MJ. Two-week comparison study of olopatadine hydrochloride nasal spray 0.6% versus azelastine hydrochloride nasal spray 0.1% in patients with vasomotor rhinitis. Allergy Asthma Proc. 2011;32(2):151–8.

    Article  CAS  PubMed  Google Scholar 

  39. Price D, Shah S, Bhatia S, Bachert C, Berger W, Bousquet J, Carr W, Hellings P, Munzel U, Scadding G, Lieberman P. A new therapy (MP29-02) is effective for the long-term treatment of chronic rhinitis. J Investig Allergol Clin Immunol. 2013;23(7):495–503.

    CAS  PubMed  Google Scholar 

  40. Berger WE, Shah S, Lieberman P, Hadley J, Price D, Munzel U, Bhatia S. Long-term, randomized safety study of MP29-02 (a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate in an advanced delivery system) in subjects with chronic rhinitis. J Allergy Clin Immunol Pract. 2014;2(2):179–85.

    Article  PubMed  Google Scholar 

  41. Naclerio R. Anticholinergic drugs in nonallergic rhinitis. World Allergy Organ J. 2009;2(8):162–5.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Bronsky EA, Druce H, Findlay SR, et al. A clinical trial of ipratropium bromide nasal spray in patients with perennial nonallergic rhinitis. J Allergy Clin Immunol. 1995;95:1117.

    Article  CAS  PubMed  Google Scholar 

  43. Grossman J, Banov C, Boggs P, et al. Use of ipratropium bromide nasal spray in chronic treatment of nonallergic perennial rhinitis, alone and in combination with other perennial rhinitis medications. J Allergy Clin Immunol. 1995;95:1123.

    Article  CAS  PubMed  Google Scholar 

  44. Raphael G, Raphael MH, Kaliner M. Gustatory rhinitis: a syndrome of food-induced rhinorrhea. J Allergy Clin Immunol. 1989;83(1):110–5.

    Article  CAS  PubMed  Google Scholar 

  45. Gevorgyan A, Segboer C, Gorissen R, van Drunen CM, Fokkens W. Capsaicin for non-allergic rhinitis. Cochrane Database Syst Rev. 2015;7:CD010591.

    Google Scholar 

  46. Meltzer EO, Ratner PH, McGraw T. Oral phenylephrine HCl for nasal congestion in seasonal allergic rhinitis: a randomized, open-label, Placebo-controlled Study. J Allergy Clin Immunol Pract. 2015;3(5):702–8.

    Article  PubMed  Google Scholar 

  47. Thongngarm T, Assanasen P, Pradubpongsa P, Tantilipikorn P. The effectiveness of oxymetazoline plus intranasal steroid in the treatment of chronic rhinitis: a randomised controlled trial. Asian Pac J Allergy Immunol. 2016;34(1):30–7.

    CAS  PubMed  Google Scholar 

  48. Baroody FM, Brown D, Gavanescu L, DeTineo M, Naclerio RM. Oxymetazoline adds to the effectiveness of fluticasone furoate in the treatment of perennial allergic rhinitis. J Allergy Clin Immunol. 2011;127(4):927–34.

    Article  CAS  PubMed  Google Scholar 

  49. Tomooka LT, Murphy C, Davidson TM. Clinical study and literature review of nasal irrigation. Laryngoscope. 2000;110(7):1189–93.

    Article  CAS  PubMed  Google Scholar 

  50. Ciprandi G. Treatment of nonallergic perennial rhinitis. Allergy. 2004;59(Suppl 76):16–22. discussion 22-3

    Article  PubMed  Google Scholar 

  51. Surda P, Fokkens WJ. Novel, alternative, and controversial therapies of rhinitis. Immunol Allergy Clin N Am. 2016;36(2):401–23.

    Article  Google Scholar 

  52. Ozcan C, Vayisoglu Y, Dogu O, et al. The effect of intranasal injection of botulinum toxin a on the symptoms of vasomotor rhinitis. Am J Otolaryngol. 2006;27(5):314–8.

    Article  CAS  PubMed  Google Scholar 

  53. Rohrbach S, Junghans K, Kohler S, et al. Minimally invasive application of botulinum toxin a in patients with idiopathic rhinitis. Head Face Med. 2009;5:18.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  54. Halderman A, Sindwani R. Surgical management of vasomotor rhinitis: a systematic review. Am J Rhinol Allergy. 2015;29(2):128–34.

    Article  PubMed  Google Scholar 

  55. Passali D, Loglisci M, Politi L, Passali GC, Kern E. Managing turbinate hypertrophy: coblation vs. radiofrequency treatment. Eur Arch Otorhinolaryngol. 2016;273(6):1449–53.

    Article  CAS  PubMed  Google Scholar 

  56. Zhang H, Micomonaco DC, Dziegielewski PT, Sowerby LJ, Weis E, Wright ED. Endoscopic vidian neurectomy: a prospective case series. Int Forum Allergy Rhinol. 2015;5(5):423–30.

    Article  PubMed  Google Scholar 

  57. Wilson KF, Spector ME, Orlandi RR. Types of rhinitis. Otolaryngol Clin North Am. 2011;44(3):549–59.

    Article  PubMed  Google Scholar 

  58. Ellis AK, Keith PK. Nonallergic rhinitis with eosinophilia syndrome. Curr Allergy Asthma Rep. 2006;6:215–20.

    Article  PubMed  Google Scholar 

  59. Rondón C, Campo P, Zambonino MA, Blanca-Lopez N, Torres MJ, Melendez L, Herrera R, Guéant-Rodriguez RM, Guéant JL, Canto G, Blanca M. Follow-up study in local allergic rhinitis shows a consistent entity not evolving to systemic allergic rhinitis. J Allergy Clin Immunol. 2014;133(4):1026–31.

    Article  PubMed  Google Scholar 

  60. Gelardi M, Guglielmi AV, Iannuzzi L, Quaranta VN, Quaranta N, Landi M, Correale M, Sonnante A, Rossini M, Mariggiò MA, Canonica GW, Passalacqua G. Local allergic rhinitis: entopy or spontaneous response? World Allergy Organ J. 2016;9(1):39.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  61. Rondón C, Campo P, Galindo L, Blanca-López N, Cassinello MS, Rodriguez-Bada JL, Torres MJ, Blanca M. Prevalence and clinical relevance of local allergic rhinitis. Allergy. 2012;67(10):1282–8.

    Article  PubMed  Google Scholar 

  62. Doshi J. Rhinitis medicamentosa: what an otolaryngologist needs to know. Eur Arch Otorhinolaryngol. 2009;266(5):623–5.

    Article  PubMed  Google Scholar 

  63. Lin CY, Cheng PH, Fang SY. Mucosal changes in rhinitis medicamentosa. Ann Otol Rhinol Laryngol. 2004;113(2):147–51.

    Article  PubMed  Google Scholar 

  64. Graf P. Rhinitis medicamentosa: a review of causes and treatment. Treat Respir Med. 2005;4:21–9.

    Article  CAS  PubMed  Google Scholar 

  65. Hallén H, Enerdal J, Graf P. Fluticasone propionate nasal spray is more effective and has a faster onset of action than placebo in treatment of rhinitis medicamentosa. Clin Exp Allergy. 1997;27(5):552–8.

    Article  PubMed  Google Scholar 

  66. Kowalski ML, Makowska JS, Blanca M, Bavbek S, Bochenek G, Bousquet J, Bousquet P, Celik G, Demoly P, Gomes ER, Niżankowska-Mogilnicka E, Romano A, Sanchez-Borges M, Sanz M, Torres MJ, De Weck A, Szczeklik A, Brockow K. Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA(#) and GA2LEN/HANNA∗. Allergy. 2011;66(7):818–29.

    Article  CAS  PubMed  Google Scholar 

  67. Baenkler H-W. Salicylate intolerance: pathophysiology, clinical spectrum, diagnosis and treatment. DeutschesÄrzteblatt International. 2008;105(8):137–42.

    Google Scholar 

  68. Caruso S, Serra A, Maiolino L, Agnello C, Di Mari L, Ruta S, Arcidiacono A, Cianci A. Cytological aspects of the nasal respiratory epithelium in reproductive-age women taking oral contraceptives. Eur J Contracept Reprod Health Care. 2006;11(4):250–7.

    Article  CAS  PubMed  Google Scholar 

  69. Philpott CM, Wild DC, Wolstensholme CR, Murty GE. The presence of ovarian hormone receptors in the nasal mucosa and their relationship to nasal symptoms. Rhinology. 2008;46(3):221–5.

    CAS  PubMed  Google Scholar 

  70. Caruso S, Serra A, Grillo C, De Leo V, Maiolino L, Agnello C, Cianci A. Prospective study evaluating olfactometric and rhinomanometric outcomes in postmenopausal women on 1 mg 17beta-estradiol and 2 mg drospirenone HT. Menopause. 2008;15(5):967–72.

    Article  PubMed  Google Scholar 

  71. Wolstenholme CR, Philpott CM, Oloto EJ, Murty GE. Does the use of the combined oral contraceptive pill cause changes in the nasal physiology in young women? Am J Rhinol. 2006;20(2):238–40.

    Article  PubMed  Google Scholar 

  72. Wild DC, Philpott CM, Wolstenholme CR, Murty GE. Does hormone replacement therapy in post-menopausal women have any effect upon nasal physiology? J Laryngol Otol. 2008;122(7):707–10.

    Article  CAS  PubMed  Google Scholar 

  73. Gilbey P, McGruthers L, Morency AM, Shrim A. Rhinosinusitis-related quality of life during pregnancy. Am J Rhinol Allergy. 2012;26(4):283–6.

    Article  PubMed  Google Scholar 

  74. Ellegard EK. Clinical and pathogenetic characteristics of pregnancy rhinitis. Clin Rev Allergy Immunol. 2004;26:149–59.

    Article  PubMed  Google Scholar 

  75. Ellegård EK. Pregnancy rhinitis. Immunol Allergy Clin N Am. 2006;26(1):119–35.

    Article  Google Scholar 

  76. Toll K, Graf P. Phenylpropanolamine's decongestive effect on the nasal mucosa of pregnant women with nasal stuffiness. Rhinology. 2006;44(4):274–7.

    PubMed  Google Scholar 

  77. Mishra A, Kawatra R, Gola M. Interventions for atrophic rhinitis. Cochrane Database Syst Rev. 2012;2:CD008280.

    Google Scholar 

  78. deShazo RD, Stringer SP. Atrophic rhinosinusitis: progress toward explanation of an unsolved medical mystery. Curr Opin Allergy Clin Immunol. 2011;11:1–7.

    Article  PubMed  Google Scholar 

  79. Baptist AP, Nyenhuis S. Rhinitis in the elderly. Immunol Allergy Clin N Am. 2016;36(2):343–57.

    Article  Google Scholar 

  80. Edelstein DR. Aging of the normal nose in adults. Laryngoscope. 1996;106(9 Pt 2):1–25.

    Article  CAS  PubMed  Google Scholar 

  81. Seiberling KA, Conley DB. Aging and olfactory and taste function. Otolaryngol Clin N Am. 2004;37(6):1209–28.

    Article  Google Scholar 

  82. Flurkey K, Stadecker M, Miller RA. Memory T lymphocyte hyporesponsiveness to non-cognate stimuli: a key factor in age-related immunodeficiency. Eur J Immunol. 1992;22(4):931–5.

    Article  CAS  PubMed  Google Scholar 

  83. Murasko DM, Nelson BJ, Silver R, et al. Immunologic response in an elderly population with a mean age of 85. Am J Med. 1986;81(4):612–8.

    Article  CAS  PubMed  Google Scholar 

  84. Gerth van Wijk RG, de Graaf-in't Veld C, Garrelds IM. Nasal hyperreactivity. Rhinology. 1999;37(2):50–5.

    CAS  PubMed  Google Scholar 

  85. Shusterman D. Nonallergic rhinitis: environmental determinants. Immunol Allergy Clin N Am. 2016;36(2):379–99.

    Article  Google Scholar 

  86. Shusterman D. The effects of air pollutants and irritants on the upper airway. Proc Am Thorac Soc. 2011;8(1):101–5.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, University of Health Sciences, Ümraniye Training and Research Hospital, Istanbul, Turkey

    Asli Sahin-Yilmaz

  2. Medical Faculty, Department of Otolaryngology, Marmara University, Istanbul, Turkey

    Cagatay Oysu

  3. Department of Surgery, Section of Otolaryngology, University of Chicago, Chicago, IL, USA

    Robert M. Naclerio

Authors
  1. Asli Sahin-Yilmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cagatay Oysu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert M. Naclerio
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Eskişehir Osmangazi University, Medical Faculty, Department of Otorhinolaryngology, Eskisehir, Turkey

    Cemal Cingi

  2. Department of Otorhinolaryngology, Medical Faculty, Kirikkale University, Kirikkale, Turkey

    Nuray Bayar Muluk

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sahin-Yilmaz, A., Oysu, C., Naclerio, R.M. (2020). Nonallergic Rhinitis. In: Cingi, C., Bayar Muluk, N. (eds) All Around the Nose. Springer, Cham. https://doi.org/10.1007/978-3-030-21217-9_41

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-21217-9_41

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21216-2

  • Online ISBN: 978-3-030-21217-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation