Advertisement

Diagnostic Criteria for a Curable Form of Chronic Rhinosinusitis: The Mucous Recirculation Syndrome

      Abstract

      In clinical practice, nonallergic rhinosinusitis (rhinopathy) is a common diagnosis of exclusion. The mucous recirculation syndrome is one incompletely defined condition that masquerades as nonallergic rhinopathy. Mucous recirculation syndrome, a curable condition, should be differentiated from nonallergic rhinopathy. The underdiagnosis of this condition is due in part to a lack of diagnostic criteria. In this article, we review the medical literature to better characterize mucous recirculation syndrome and to establish diagnostic criteria for it.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kaliner M.A.
        • Baraniuk J.N.
        • Benninger M.
        • et al.
        Consensus definition of nonallergic rhinopathy (NAR), previously referred to as vasomotor rhinitis (VMR), nonallergic rhinitis, and/or idiopathic rhinitis.
        World Allergy Organ J. 2009; 2: 119-120
        • Settipane R.A.
        Other causes of rhinitis: mixed rhinitis, rhinitis medicamentosa, hormonal rhinitis, rhinitis of elderly, and gustatory rhinitis.
        Immunol Allergy Clin North Am. 2011; 31: 457-467
        • Kaliner M.A.
        Nonallergic rhinopathy (formerly known as vasomotor rhinitis).
        Immunol Allergy Clin North Am. 2011; 31: 441-455
        • Reed J.S.
        • deShazo R.D.
        • Houle T.T.
        • Stringer S.
        • Wright L.B.
        • Moak S.J.
        Clinical features of sarcoid rhinosinusitis.
        Am J Med. 2010; 123: 856-862
        • Ly T.
        • deShazo R.D.
        • Oliver J.
        • Stringer S.
        • Daley W.
        • Stodard C.
        Diagnostic criteria for atrophic rhinosinusitis.
        Am J Med. 2009; 122: 747-753
        • deShazo R.D.
        • Swain R.E.
        Diagnostic criteria for allergic fungal sinusitis.
        J Allergy Clin Immunol. 1995; 96: 24-35
        • Messerklinger W.
        Endoscopy of the Nose.
        Urban Schwartzenberg, Baltimore, MD1978
        • Yanagisawa E.
        • Weaver E.M.
        Endoscopic view of recirculation phenomena of sphenoid sinus drainage.
        Ear Nose Throat J. 1996; 75: 68-70
        • Matthews B.L.
        • Burke A.J.C.
        Recirculation of mucus via accessory ostia causing chronic maxillary sinus disease.
        Otolaryngol Head Neck Surg. 1997; 117: 422-423
        • Kane K.J.
        Recirculation of mucus as a cause of persistent sinusitis.
        Am J Rhinol. 1997; 11: 361-369
        • Chung S.K.
        • Cho D.Y.
        • Dhong H.J.
        Computed tomogram findings of mucous recirculation between the natural and accessory ostia of the maxillary sinus.
        Am J Rhinol. 2002; 16: 265-268
        • Coleman J.R.
        • Duncavage J.A.
        Extended middle meatal antrostomy: the treatment of circular flow.
        Laryngoscope. 1996; 106: 1214-1217
        • Yanagisawa E.
        • Yanagisawa K.
        Endoscopic view of recirculation phenomenon of the maxillary sinus.
        Ear Nose Throat J. 1997; 76: 196-198
        • Chung S.K.
        • Dhong H.J.
        • Na D.G.
        Mucus circulation between accessory ostium and natural ostium of maxillary sinus.
        J Laryngol Otol. 1999; 113: 865-867
        • Gutman M.
        • Houser S.
        Iatrogenic maxillary sinus recirculation and beyond.
        Ear Nose Throat J. 2003; 82: 61-63
        • Kane K.J.
        Persistent sinusitis from recirculating mucus after inferior turbinectomy.
        Int Congr Ser. 2003; 1240: 463-467
        • Stammberger H.R.
        Functional Endoscopic Sinus Surgery. The Messerklinger Technique.
        B.C. Decker, Philadelphia1991
        • Settipane R.A.
        • Charnock D.R.
        Epidemiology of rhinitis: allergic and nonallergic.
        in: Baraniuk J.N. Shusterman D. Nonallergic Rhinitis. Informa, New York2007: 23Y34
        • Mladina R.
        • Vukovic K.
        • Poje G.
        The two holes syndrome.
        Am J Rhinol Allergy. 2009; 23: 602-604
        • Mladina R.
        • Skitarelić N.
        • Casale M.
        Two holes syndrome (THS) is present in more than half of the postnasal drip patients?.
        Acta Otolaryngol. 2010; 130: 1274-1277
        • Webb D.R.
        • Meltzer E.O.
        • Finn A.F.
        • et al.
        Intranasal fluticasone is effective for perennial nonallergic rhinitis with or without eosinophilia.
        Ann Allergy Asthma Immunol. 2002; 88: 385-390
        • Banov C.H.
        • Lieberman P.
        • Vasomotor Rhinitis Study Groups
        Efficacy of azelastine nasal spray in the treatment of vasomotor (perennial nonallergic) rhinitis.
        Ann Allergy Asthma Immunol. 2001; 86: 28-35