For patients with persistent rhinorrhea, accurate diagnosis and targeted treatment are essential for optimal outcomes. At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, patients benefit from precise diagnostics and innovative in-office procedures for vasomotor rhinitis (VMR). Montefiore Einstein is one of the few centers in the Bronx and northern New York/Westchester County region offering specialized care for both routine and complex cases.

"A common misconception among patients is that all cases of chronic runny nose are allergy related," explains      Nadeem Akbar, MD, Director of Rhinology, Endoscopic Skull Base Surgery at Montefiore Einstein and Associate Professor of Otorhinolaryngology – Head and Neck Surgery and Neurosurgery at the Albert Einstein College of Medicine. "Vasomotor rhinitis often becomes apparent when standard allergy treatments don't provide relief. It is triggered by neurologic responses to irritants, including certain foods and drinks, rather than allergic reactions."

This distinction is crucial for treatment success. While antihistamines and steroids are the standard treatments for allergic rhinitis, VMR responds better to targeted approaches. First-line treatment often includes ipratropium bromide (Atrovent) nasal spray. For patients seeking longer-term solutions, the Department offers several in-office procedures.

"We provide multiple minimally invasive options that can be performed right in our office," notes Dr. Akbar. These include cryotherapy using ClariFix®, which freezes nerve endings and can provide relief for three to six months, and radiofrequency ablation, which uses thermal energy to target affected tissue with results lasting six months to one year. Both procedures are performed under local anesthesia and serve as effective alternatives to daily medications. For cases requiring more intensive intervention, the Department also performs advanced procedures using minimally invasive endoscopic techniques, such as posterior nasal neurectomy and vidian neurectomy.

Dr. Akbar and his team are committed to working collaboratively with referring physicians on concerns about VMR, seeing patients within a week or less when necessary and maintaining open communication throughout treatment. The Department serves as a valuable resource for challenging cases, including those where standard treatments have failed or where cerebrospinal fluid (CSF) leaks need to be ruled out a critical differential diagnosis that the team routinely manages.

The Department's rhinology division extends beyond clinical care. Dr. Christina Fang is advancing research through RegENT, a comprehensive ear, nose and throat (ENT) database that aggregates data from multiple institutions to better understand rhinologic disease processes. Dr. Patrick Colley is pioneering minimally invasive approaches, including transorbital endoscopic procedures that enhance patient recovery without compromising care quality.

For more information about contributions to research and treatment from the Department of Otorhinolaryngology – Head and Neck Surgery, visit highlights.montefiore.org/otorhinolaryngology.