The principal symptoms of vasomotor rhinitis have thus been due to an autonomic input to the nose, he said. It has also been suggested that the autonomic nervous system reacts with the inflammatory response…basically an increase in sympathetic activity overall has an anti-inflammatory or immunosuppressive effect.
Explore this issue:
January 2007It is a response of the nasal mucosa…to environmental or emotional stimuli and many people feel this may occur in conjunction with allergic rhinitis; however, its ideology remains undetermined.
Dr. Loehrl said his team found that patients diagnosed with vasomotor rhinitis have evidence of autonomic nervous system dysfunction characterized by a relative hypoactivity of the sympathetic component. Patients with both disorders tend to have the same hypoactive sympathetic dysfunction, but to a greater degree.
Based on what we know…this might be playing a role in the patients’ upper airway inflammatory response, he said.
Examine All Angles
Calling herself a cleanup woman and philosopher, Gayle E. Woodson, MD, of the University of Illinois-Springfield, closed out the session talking about the importance of looking at the patient form all angles when diagnosing and treating diseases in this realm.
More than one thing that can cause laryngitis, she said. The upper airway and digestive tract are inter-related.
Let’s think for a moment, what is the single most common cause of acute laryngitis? It is upper respiratory infection and that is the most common cause of what will lead to-self-perpetuating chronic laryngitis.
Dr. Woodson said other inciting events-acute allergy, vocal trauma, severe reflux episodes, chronic nasal congestion-can all play a part in bringing laryngitis to the fore.
You can get the acute event out of the way and still have this [ongoing] cycle, she said. You have to break into that cycle somewhere.
Acid reflux can be a very important part of that. You can have a negative pH probe, but that doesn’t mean you’re not refluxing every three to four days and didn’t happen to reflux on the day the study was done.
Medications-from an otolaryngologist or other doctor-can also be contributing factors, Dr. Woodson said.
There is not one magic bullet to treat this, she said. You have to think about all of the contributing factors.
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