A new, simple and effective local treatment of allergic and
vasomotor rhinitis is presented. Using 15 per cent
silver nitrate, bilateral chemical
cautery of the anterior part of the nasal septum and inferior turbinates has been carried out at weekly intervals on 1 to 5 occasions, in 41 cases. No distinction was made between
allergic rhinitis and
vasomotor rhinitis. 92.6 per cent of cases belonged to the age group of 11 to 50 years. There was a slight predominance of female over male patients in this study. Only those cases were selected who had
sneezing as the presenting symptom, while 17 per cent of these patients also suffered from
asthma. The eosinophil count in the blood was below 5 per cent in 73.2 per cent of cases, and was above 10 per cent in 9.8 per cent of cases. Eosinophils were present in the nasal secretions of of 66.6 per cent of patients. Intestinal parasites were detected in the stools of 19.5 per cent of cases. No significant quantity of methaemoglobin was detected in the blood of any patient.
Silver nitrate was applied after topical anaesthesia with 4 per cent
lignocaine solution. The majority of patients had 2 to 4 applications. 68.3 per cent of patients had good relief, particularly from
sneezing and watering of the nose. If patients treated with only a single application of
silver nitrate are excluded from the series, 79.4 per cent patients reported relief. Significantly, out of 7 cases who were suffering from
allergic rhinitis as well as
asthma, 57.1 per cent of cases had freedom from the
asthma. Among 3 patients who had no relief with earlier intranasal
hydrocortisone injections, 66.6 per cent cases had good relief with
silver nitrate. One patient who had good relief from
allergic rhinitis developed
anosmia after this treatment and some patients experienced transient
sneezing and rhinorrhoea after the application of
silver nitrate. Long-term results are awaited and it is suggested that further studies are necessary regarding the number of applications, the interval between applications, the strength of the
silver nitrate solution, and the possible use of other chemical or physical agents for this mode of treatment.