Nonallergic Rhinitis

  • Asli Sahin-Yilmaz
  • Cagatay Oysu
  • Robert M. Naclerio


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.


Nonallergic rhinitis Vasomotor rhinitis or idiopathic rhinitis Nonallergic rhinitis with eosinophilia syndrome (NARES) Drug-induced rhinitis Hormonal-induced rhinitis Atrophic rhinitis Senile rhinitis Gustatory rhinitis Chronic rhinosinusitis 


  1. 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.PubMedGoogle Scholar
  2. 2.
    Mastin T. Recognizing and treating non-infectious rhinitis. J Am Acad Nurse Pract. 2003;15(9):398–409.PubMedGoogle Scholar
  3. 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.PubMedGoogle Scholar
  4. 4.
    Papadopoulos NG, Guibas GV. Rhinitis subtypes, endotypes, and definitions. Immunol Allergy Clin N Am. 2016;36(2):215–33.Google Scholar
  5. 5.
    Kaliner MA. Nonallergic rhinopathy (formerly known as vasomotor rhinitis). Immunol Allergy Clin N Am. 2011;31(3):441–55.Google Scholar
  6. 6.
    Settipane RA, Charnock DR. Epidemiology of rhinitis: allergic and nonallergic. Clin Allergy Immunol. 2007;19:23–34.PubMedGoogle Scholar
  7. 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.PubMedGoogle Scholar
  8. 8.
    Settipane RA. Epidemiology of vasomotor rhinitis. World Allergy Organ J. 2009;2(6):115–8.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Kaliner MA. Azelastine and olopatadine in the treatment of allergic rhinitis. Ann Allergy Asthma Immunol. 2009;103(5):373–80.PubMedGoogle Scholar
  10. 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.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Baroody FM. Nonallergic rhinitis: mechanism of action. Immunol Allergy Clin N Am. 2016;36(2):279–87.Google Scholar
  12. 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.PubMedGoogle Scholar
  13. 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.PubMedGoogle Scholar
  14. 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.PubMedGoogle Scholar
  15. 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.PubMedPubMedCentralGoogle Scholar
  16. 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.PubMedGoogle Scholar
  17. 17.
    Joe SA. Nonallergic rhinitis. Facial Plast Surg Clin North Am. 2012;20(1):21–30.PubMedGoogle Scholar
  18. 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.PubMedPubMedCentralGoogle Scholar
  19. 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.Google Scholar
  20. 20.
    Greiwe J, Bernstein JA. Nonallergic rhinitis: diagnosis. Immunol Allergy Clin N Am. 2016;36(2):289–303.Google Scholar
  21. 21.
    Stankiewicz JA, Chow JM. Nasal endoscopy and the definition and diagnosis of chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2002;126(6):623–7.PubMedGoogle Scholar
  22. 22.
    Philip G, Togias AG. Nonallergic rhinitis. Pathophysiology and models for study. Eur Arch Otorhinolaryngol. 1995;252(Suppl 1):S27–32.PubMedGoogle Scholar
  23. 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.PubMedGoogle Scholar
  24. 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.PubMedGoogle Scholar
  25. 25.
    Meltzer EO. The treatment of vasomotor rhinitis with intranasal corticosteroids. World Allergy Organ J. 2009;2(8):166–79.PubMedPubMedCentralGoogle Scholar
  26. 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.PubMedGoogle Scholar
  27. 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.PubMedGoogle Scholar
  28. 28.
    Daramola OO, Kern RC. An update regarding the treatment of nonallergic rhinitis. Curr Opin Otolaryngol Head Neck Surg. 2016;24(1):10–4.PubMedGoogle Scholar
  29. 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.PubMedGoogle Scholar
  30. 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.PubMedGoogle Scholar
  31. 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.PubMedGoogle Scholar
  32. 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.PubMedGoogle Scholar
  33. 33.
    Lieberman PL, Smith P. Nonallergic rhinitis: treatment. Immunol Allergy Clin N Am. 2016;36(2):305–19.Google Scholar
  34. 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.PubMedGoogle Scholar
  35. 35.
    Kaliner MA. A novel and effective approach to treating rhinitis with nasal antihistamines. Ann Allergy Asthma Immunol. 2007;99(5):383–90.PubMedGoogle Scholar
  36. 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.PubMedGoogle Scholar
  37. 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.PubMedGoogle Scholar
  38. 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.PubMedGoogle Scholar
  39. 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.PubMedGoogle Scholar
  40. 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.Google Scholar
  41. 41.
    Naclerio R. Anticholinergic drugs in nonallergic rhinitis. World Allergy Organ J. 2009;2(8):162–5.PubMedPubMedCentralGoogle Scholar
  42. 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.PubMedGoogle Scholar
  43. 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.PubMedGoogle Scholar
  44. 44.
    Raphael G, Raphael MH, Kaliner M. Gustatory rhinitis: a syndrome of food-induced rhinorrhea. J Allergy Clin Immunol. 1989;83(1):110–5.PubMedGoogle Scholar
  45. 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. 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.PubMedGoogle Scholar
  47. 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.PubMedGoogle Scholar
  48. 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.PubMedGoogle Scholar
  49. 49.
    Tomooka LT, Murphy C, Davidson TM. Clinical study and literature review of nasal irrigation. Laryngoscope. 2000;110(7):1189–93.PubMedGoogle Scholar
  50. 50.
    Ciprandi G. Treatment of nonallergic perennial rhinitis. Allergy. 2004;59(Suppl 76):16–22. discussion 22-3PubMedGoogle Scholar
  51. 51.
    Surda P, Fokkens WJ. Novel, alternative, and controversial therapies of rhinitis. Immunol Allergy Clin N Am. 2016;36(2):401–23.Google Scholar
  52. 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.PubMedGoogle Scholar
  53. 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.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Halderman A, Sindwani R. Surgical management of vasomotor rhinitis: a systematic review. Am J Rhinol Allergy. 2015;29(2):128–34.PubMedGoogle Scholar
  55. 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.PubMedGoogle Scholar
  56. 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.PubMedGoogle Scholar
  57. 57.
    Wilson KF, Spector ME, Orlandi RR. Types of rhinitis. Otolaryngol Clin North Am. 2011;44(3):549–59.PubMedGoogle Scholar
  58. 58.
    Ellis AK, Keith PK. Nonallergic rhinitis with eosinophilia syndrome. Curr Allergy Asthma Rep. 2006;6:215–20.PubMedGoogle Scholar
  59. 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.PubMedGoogle Scholar
  60. 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.PubMedPubMedCentralGoogle Scholar
  61. 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.PubMedGoogle Scholar
  62. 62.
    Doshi J. Rhinitis medicamentosa: what an otolaryngologist needs to know. Eur Arch Otorhinolaryngol. 2009;266(5):623–5.PubMedGoogle Scholar
  63. 63.
    Lin CY, Cheng PH, Fang SY. Mucosal changes in rhinitis medicamentosa. Ann Otol Rhinol Laryngol. 2004;113(2):147–51.PubMedGoogle Scholar
  64. 64.
    Graf P. Rhinitis medicamentosa: a review of causes and treatment. Treat Respir Med. 2005;4:21–9.PubMedGoogle Scholar
  65. 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.PubMedGoogle Scholar
  66. 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.PubMedGoogle Scholar
  67. 67.
    Baenkler H-W. Salicylate intolerance: pathophysiology, clinical spectrum, diagnosis and treatment. DeutschesÄrzteblatt International. 2008;105(8):137–42.Google Scholar
  68. 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.PubMedGoogle Scholar
  69. 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.PubMedGoogle Scholar
  70. 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.PubMedGoogle Scholar
  71. 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.PubMedGoogle Scholar
  72. 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.PubMedGoogle Scholar
  73. 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.PubMedGoogle Scholar
  74. 74.
    Ellegard EK. Clinical and pathogenetic characteristics of pregnancy rhinitis. Clin Rev Allergy Immunol. 2004;26:149–59.PubMedGoogle Scholar
  75. 75.
    Ellegård EK. Pregnancy rhinitis. Immunol Allergy Clin N Am. 2006;26(1):119–35.Google Scholar
  76. 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.PubMedGoogle Scholar
  77. 77.
    Mishra A, Kawatra R, Gola M. Interventions for atrophic rhinitis. Cochrane Database Syst Rev. 2012;2:CD008280.Google Scholar
  78. 78.
    deShazo RD, Stringer SP. Atrophic rhinosinusitis: progress toward explanation of an unsolved medical mystery. Curr Opin Allergy Clin Immunol. 2011;11:1–7.PubMedGoogle Scholar
  79. 79.
    Baptist AP, Nyenhuis S. Rhinitis in the elderly. Immunol Allergy Clin N Am. 2016;36(2):343–57.Google Scholar
  80. 80.
    Edelstein DR. Aging of the normal nose in adults. Laryngoscope. 1996;106(9 Pt 2):1–25.PubMedGoogle Scholar
  81. 81.
    Seiberling KA, Conley DB. Aging and olfactory and taste function. Otolaryngol Clin N Am. 2004;37(6):1209–28.Google Scholar
  82. 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.PubMedGoogle Scholar
  83. 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.PubMedGoogle Scholar
  84. 84.
    Gerth van Wijk RG, de Graaf-in't Veld C, Garrelds IM. Nasal hyperreactivity. Rhinology. 1999;37(2):50–5.PubMedGoogle Scholar
  85. 85.
    Shusterman D. Nonallergic rhinitis: environmental determinants. Immunol Allergy Clin N Am. 2016;36(2):379–99.Google Scholar
  86. 86.
    Shusterman D. The effects of air pollutants and irritants on the upper airway. Proc Am Thorac Soc. 2011;8(1):101–5.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Asli Sahin-Yilmaz
    • 1
  • Cagatay Oysu
    • 2
  • Robert M. Naclerio
    • 3
  1. 1.Department of OtorhinolaryngologyUniversity of Health Sciences, Ümraniye Training and Research HospitalIstanbulTurkey
  2. 2.Medical Faculty, Department of OtolaryngologyMarmara UniversityIstanbulTurkey
  3. 3.Department of Surgery, Section of OtolaryngologyUniversity of ChicagoChicagoUSA

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