Abstract: . . .  inhaled steroids and cromolyn have minimal side effects and are approved for use in aviation personnel, as are three non-sedating antihistamines (Claritin, Clarinex, and Allegra). Allergic rhinitis may be mimicked by Vasomotor Rhinitis , which may consist of rhinorrhea, sneezing, and congestion. The congestion is often seen as alternating, sometimes severe, nasal obstruction. Inciting factors include temperature and humidity changes, odors, irritants, recumbency, and emotion. Treatment of vasomotor rhinitis with inhaled nasal steroids can be effective, and, if symptoms aren't disabling, no waiver is required. The potential for VR to cause barotrauma is nil. ICD-9 CODES: 477.9 Allergic/Vasomotor Rhinitis 477.98 Allergic Rhinitis , treated with steroids 477.0 Allergic Rhinitis , due to pollen 477.8 Allergic Rhinitis , due to other allergens P22.60 Functional Endoscopic Sinus Surgery (FESS) U.S. Navy Aeromedical Reference and Waiver Guide ENT - 2 Page 3 ALLERGIC RHINITIS WORKSHEET EXAMINING FACILITY: FACILITY UIC: TODAY'S DATE: EXAMINER'S PHONE #: REQUESTING WAIVER? REQUESTING TO ELIMINATE WAIVER? HISTORY SYMPTOMS FREQUENCY TREATMENT PRIOR PROBLEMS RHINORRHEA SPRING None EAR BAROTRAUMA CLEAR SUMMER OTC Med . . .
. . .  chamber flight(s) If polyps are currently present, the following additional information is also required: 1. Sinus CT (to look for the sinus disease that often accompanies polyps) TREATMENT: Resection of nasal polyps is advisable in most cases. This is a must if a waiver is to be considered with one exception. If polyps are very small and in no way blocking the middle meatus according to the ENT consultant, then a waiver may be recommended even without surgery. Topical nasal steroids may be needed to keep these from enlarging. DISCUSSION: Nasal polyps have a poorly understood etiology and tend to be recurrent. Allergic polyps are relatively uncommon considering the large number of allergic rhinitis patients on active duty. Inflammatory nasal polyps may be more common in our population, and are frequently the result of chronic sinusitis. They are usually found in and near the middle meatus, which is why even a small polyp may lead to sinus barotrauma. Polypoid middle turbinates are somewhat more common, and don't cause barotraumas frequently. They often can be reduced dramatically in size by topical nasal steroid sprays, and rarely require surgery. If there is no history of barotrauma or chronic sinusitis, the presence of polypoid turbinates alone is NCD. As opposed to nasal polyps, sinus polyps are NCD, but the underlying diseases which led to their formation may be CD. However, . . .
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