Variants of rhinitis medicamentosa treatment: a systematic review

Nasal breathing dysfunction resulting from uncontrolled decongestant use is an extremely urgent public health problem. This condition is referred to as rhinitis medicamentosa. Despite the high incidence of patients with this diagnosis, there is still no consensus on treatment tactics. The purpose of this study was to review the available literature on rhinitis medicamentosa treatment and summarize the findings reported in different approaches.

We conducted a systematic review of PubMed (MEDLINE), The Cochrane Library, and Clinicaltrials.gov databases to identify studies that describe conservative and surgical treatments for rhinitis medicamentosa.

Twelve studies, including 373 patients, met the search criteria. Out of these, seven studies used topical intranasal steroids like budesonide or fluticasone propionate sprays as a conservative treatment. One study used dexamethasone nasal drops. Five studies involved surgical treatment for patients; three of these studies used radiofrequency ablation to reduce the inferior turbinates, while the other two studies used diode laser and kinetic stimulation, respectively.

All studies included in this systematic review demonstrate the high efficacy of the separately presented treatment methods. However, the different design and evaluation methods do not allow us to systematize the data and develop a unified algorithm for treating rhinitis medicamentosa. We see the potential for conducting comparative evidence-based studies on a larger sample, along with the evaluation of long-term treatment results.