In vasomotor rhinitis (non-allergic, non-infectious rhinitis), the imbalance between which divisions of the autonomic nervous system is responsible for nasal congestion and watery rhinorrhoea?

• A Sympathetic overactivity causing mucosal engorgement and hypersecretion
• B Sensory C-fibre hypersensitivity causing neurogenic inflammation without autonomic involvement
• C Mast cell degranulation triggered by non-IgE mechanisms causing eosinophilic infiltration
• D Parasympathetic overactivity (cholinergic dominance) causing vasodilation and hypersecretion with sympathetic underactivity ✓

Explanation

Vasomotor rhinitis is characterized by nasal mucosal hyperresponsiveness due to predominant parasympathetic (cholinergic) tone over sympathetic innervation of the nasal vasculature and mucous glands. Increased parasympathetic activity via the vidian nerve (containing parasympathetic fibres from the sphenopalatine ganglion) causes vasodilatation with nasal congestion, and excessive mucous gland secretion producing watery rhinorrhoea. Treatment options include ipratropium bromide nasal spray (anticholinergic) and vidian neurectomy for refractory cases.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.