Symptoms usually include nasal congestion, postnasal drainage, and excessive mucous production. However, the patient’s allergy testing was negative. This means that the “allergen” could still be causing symptoms. This in turn can irritate the mucous membranes of the nose and sinuses.
The diagnosis can be made, primarily in an academic center, by performing a nasal allergen provocation test. This consists of administering allergens such as local pollen directly into the nasal cavity to determine if this triggers an allergic reaction. This test is not performed in our office.
In practical terms, this disorder is treated similar to allergic rhinitis. Medications may be prescribed such as:
- various nasal sprays
- antihistamines
- use of saline sinus irrigations
- Allergen immunotherapy
Sometimes there are structural problems present such as enlarged turbinates. Performing a turbinate reduction procedure can be of benefit. This procedure can help resolve nasal congestion and obstruction symptoms. If the condition is associated with frequent sinus infections, balloon sinus dilation of the affected sinuses may be of help.
