What is vasomotor rhinitis?

Abstract

The use of the term "vasomotor rhinitis" has been abandoned in many countries and guidelines because it assumes a mechanism of vascular changes which do not exist. The condition previously described by the term VMR is a form of neurogenic nonallergic rhinitis. Nonallergic rhinitis (NAR) encompasses rhinitis symptoms without allergic sensitisation or infectious aetiology. Two major subtypes exist: an eosinophilic inflammatory endotype including nonallergic rhinitis with eosinophilia (NARES), local allergic rhinitis (LAR) and NSAID-exacerbated respiratory disease (N-ERD) and a neurogenic endotype which includes gustatory rhinitis, rhinitis of the elderly and idiopathic rhinitis. This second endotype includes what was called VMR. Vasomotor rhinitis therefore can be defined as a nonallergic type of rhinitis not connected to allergic responses, infective agents, anatomical anomaly, systemic disorders or drug misuse. The diagnosis is made after excluding other potential diagnoses and after negative allergy testing. There may be multiple causes. In this chapter, VMR will be defined as an essential, chronic, nonallergic pattern of rhinitis in which cutaneous allergy testing is negative, there is no rise in serum IgE and nasal cytology fails to show evidence of inflammation. In this chapter, VMR is reviewed in detail.