Nasal mastocytosis.

Abstract

AbstractThe treatment of obstructed nose due to removable lesions such as adenoidal hypertrophy, nasal polyps, tumors or deviation of the septum is surgical. In the non‐surgical obstructed nose the establishment of the proper diagnosis in order to institute proper therapy is obvious. The allergic nose is treatable in most instances with antihistamines, decongestants, and, appropriately, by desensitization. There is a considerable body of patients with non‐allergic perennial rhinitis who have no surgical obstruction, and who have been treated, usually for years, with the usual modes appropriate for the allergic nose. The results universally are poor.Nasal biopsies have been used to show a marked difference of infiltration of the mast cell in the submucosa of patients with perennial rhinitis who have neither obstruction due to surgically treatable conditions or due to allergic rhinitis. It is postulated that the mast cells infiltrate the nasal mucosa in response to factors yet to be determined. The mast cell contains chemical mediators which when released into the nasal tissue cause the symptoms of perennial rhinitis. The diagnosis cannot be made by direct visualization or even by nasal mucus smears but only made by biopsy. Surgery and allergy management usually fail in these patients, and usually they respond only to an honest explanation of the condition and short term steroid therapy.