Sniffing out the Runny Nose

PROGRAM DESCRIPTION: Every otolaryngologist encounters patients with a runny nose – whether that be anterior rhinorrhea or post-nasal drip/discharge. Chronic rhinitis is characterized into allergic and non-allergic rhinitis based on the presence (allergic rhinitis) or absence (non-allergic rhinitis) of allergen specific IgE mediated response. Non-allergic rhinitis is a common symptom evaluated in Otolaryngology clinics, affecting approximately 30 million Americans. NAR is associated with a negative impact on patient quality of life, and despite evidence to support topical pharmacotherapies, many patients remain symptomatic and are considered surgical/procedural candidates. The primary goal of this expert series is to provide clinicians who evaluate patients with chronic rhinitis with evidence-based comparisons of the medical and surgical options available for patients with debilitating non-allergic rhinitis. The second aim of this series is to provide the audience with detailed surgical techniques for treatment of chronic rhinitis as well as options for in-office topical anesthetic regimens. Surgical /procedural techniques evaluated include inferior turbinate reduction, botulism toxin injection, endoscopic vidian neurectomy, posterior nasal neurectomy, and ablation of the posterior nasal nerve. Post-nasal discharge has been attributed to sinonasal, laryngeal, and esophageal diseases. We will explore a step-wise approach to evaluation and treatment of post-nasal discharge.

OUTCOME OBJECTIVE 1: Describe the pathophysiology of non-allergic rhinitis
Evaluate the current evidence in support of the medical and surgical treatment of non-allergic rhinitis.

OUTCOME OBJECTIVE 2: Examine in-office anesthetic regimens for procedural/surgical treatment of non-allergic rhinitis
Compare surgical techniques for the surgical treatment of non-allergic rhinitis.

OUTCOME OBJECTIVE 3: Implement surgical technique for treatment of non-allergic rhinitis
Discuss evaluation and management of post-nasal discharge.

BACKGROUND STATEMENT: Anterior and posterior rhinorrhea/rhinitis are commonly encountered chief complaints in Otolaryngology clinics. This session has been well attended and rated in two prior meetings as this session comprehensively addresses rhinorrhea from a multi-disciplinary approach.

Comprehensive Otolaryngology Track Statement :