This protocol addresses patients with vasomotor rhinitis experiencing the full symptom complex: rhinorrhea, sneezing, postnasal drip, and nasal congestion — in whom first-line pharmacotherapy has not produced adequate improvement in congestion.
An initial regimen of empiric topical decongestants, oral decongestants, or oral antihistamines was trialled. This protocol applies when that approach has not achieved the key goal of improvement in congestion.
For seriously affected patients who do not respond to prior therapies, management moves to specialist-administered interventions. The full structured regimen — including which interventions, by whom, and under what conditions — is available in the complete protocol.
If the patient presents with the full range of symptoms including rhinorrhea with sneezing, postnasal drip, and congestion, a topical antihistamine may be initiated.
These therapies include topical decongestants, oral decongestants, and local application of silver nitrate solutions by an otolaryngologist.
Sphenopalatine blocks, also performed by otolaryngologists, are reserved for seriously affected patients who do not respond to other interventions and whose lives are altered significantly by their symptoms.