Most patients with rhinitis or rhinosinusitis have an allergic, infectious, irritant related or mast cell disorder. A number of other disorders may present with findings that cause overlapping symptoms and which may be misdiagnosed for some time.


A complete exam of the nasal cavity and adjacent structures should be performed if any of the following are present:

(1) the patient does not respond as expected to standard therapy

(2) the patient has unexplained systemic findings

(3) the patient has lymphadenopathy

(4) there is new onset of symptoms in a child

(5) there is new onset of symptoms in an elderly adult


Autoimmune vasculitis:

(1) Wegener's granulomatosis

(2) Churg Strauss syndrome

(3) midline granuloma

(4) relapsing polychondritis

(5) sarcoidosis



(1) deviated nasal septum

(2) structural anomaly of the nasal septal wall

(3) facial trauma

(4) hypertrophy of the adenoids

(5) foreign body

(6) benign nasal tumor, including nasal polyps (which often are a part of chronic rhinosinusitis)

(7) malignant nasal tumor

(8) choanal atresia

(9) cleft palate

(10) acromegaly



(1) pharyngonasal reflux

(2) cerebrospinal fluid (CSF) rhinorrhea

(3) ciliary dyskinesia syndrome

(4) amyloidosis

(5) parasite


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