This protocol is for patients with vasomotor rhinitis who present with nasal obstruction and nasal congestion but no rhinorrhea, and whose symptoms have not adequately responded to a first-line intranasal corticosteroid.
Predominant nasal obstruction and congestion without rhinorrhea is the defining feature of this presentation. With this pattern, topical corticosteroids are a well-supported starting point — but not all patients reach sufficient improvement in obstruction and congestion scores on that approach alone.
First-line therapy with topical corticosteroids intranasally did not achieve the expected improvement in nasal obstruction and congestion scores. The protocol below addresses the structured next step for these patients.