Clinical review of 33 cases of rhinitis medicamentosa by decongestant nasal spray

Abstract

Long-term use of decongestant nasal spray (alpha adrenergic agonist) causes nasal congestion by rhinitis medicamentosa. Subjects and methods: We clinically reviewed the cases of 33 patients of rhinitis medicamentosa (23 men, 10 women: mean age, 44.4 ± 15.6 years) treated with nasal steroid sprays instead of decongestant nasal sprays in our clinic from October, 2011 to December, 2012. Results: Periods of drug use were generally long. Only 7 cases had a duration of use less than 1 year, and about half (48.5%) had a duration of use longer than 2 years. Causes of use included acute inflammation (n = 6), chronic rhinosinusitis (n = 2). and allergic rhinitis (n = 20) and unknown cause (n = 5). About two-third of the patients failed to answer questions concerning their use of decongestant nasal spray in a questionnaire prior to examination: therefore, careful observation was necessary. Among the 33 cases, 31 were followed up, all of whom showed improvement and stopped using decongestant nasal spays within 4 weeks. Periods for recovery were as follows: 3 days in 19 cases (61.3%) and 1 week in 25 cases (80.6%). Duration of drug use did not correlate with the period required for recovery: therefore, these results suggest that patients with long-term drug use are able to improve quickly. Conclusion: Rhinitis medicamentosa with nasal congestion appears readily reversible with suitable treatment.