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Otolaryngology (ENT)75 papers

Chronic rhinitis

Last edited: 4/16/2026

Overview

Chronic rhinitis involves persistent nasal symptoms such as congestion, discharge, and itching, lasting for more than 12 weeks, often without identifiable structural abnormalities or severe pathology. 1

Diagnosis

  • Key Diagnostic Criteria: Persistent nasal symptoms lasting over 12 weeks, often including postnasal drip and throat clearing.
  • Recommended Tests:
    • - Symptom-scoring questionnaires (e.g., RSI, SNOT-20, GETS). - Saccharin clearance time. - Nasendoscopy. - Skin prick allergy testing. - CT of sinuses (if indicated).
  • Grading: Interpretation of results compared to published normative values to rule out significant pathology. 1

    • Management

  • First-Line Treatments:
    • - Nasal saline irrigation. - Intranasal corticosteroids (specific doses not detailed in abstracts). - Antihistamines or mast cell stabilizers for allergic components.
  • Adjunctive Treatments:
    • - Leukotriene receptor antagonists. - Decongestants (short-term use only). - Non-pharmacological interventions (e.g., environmental control measures). 1

    Special Populations

  • Pregnancy: Limited specific guidance provided in abstracts; intranasal corticosteroids are generally considered safe but should be used cautiously and at the lowest effective dose. 1
  • Pediatrics: No specific details provided in the abstracts.
  • Elderly: No specific details provided in the abstracts.
  • Comorbidities: Management should consider overlapping symptoms and potential drug interactions, though specific recommendations are not detailed in the abstracts. 1

    • Key Recommendations

  • Referral for specialist investigation in chronic catarrh patients in primary care may not significantly alter management or patient outcomes and should be considered judiciously to avoid unnecessary costs and patient anxiety. (Evidence: Moderate) 1
  • Utilize symptom-specific questionnaires alongside basic investigations like saccharin clearance time and nasendoscopy to differentiate between significant pathology and functional rhinitis. (Evidence: Moderate) 1
  • First-line pharmacologic management should include intranasal corticosteroids and antihistamines, tailored to the underlying etiology (allergic vs non-allergic). (Evidence: Expert opinion) 1

    • References

    1 Cathcart RA, Wilson JA. Should chronic catarrh patients seen in primary care be referred for further investigations?. International journal of clinical practice 2011. link

    Original source

    1. [1]
      Should chronic catarrh patients seen in primary care be referred for further investigations? — Cathcart RA, Wilson JA International journal of clinical practice (2011)
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