Referral to specialist otolaryngologist may be advisable

EDITOR—Although the 10-minute consultation on rhinitis serves as a useful guide for treatment of this common condition, certain points merit clarification.1

We agree that unilateral nasal blockage and bleeding warrant prompt referral since these symptoms may indicate an underlying malignancy. Contrary to the authors' suggestion, however, this is an uncommon presentation of nasopharyngeal carcinoma, which is more frequently associated with unilateral glue ear or cervical lymphadenopathy. Examination of the nose by an experienced doctor using adequate illumination is essential to exclude other diagnoses, such as septal deflection, turbinate enlargement, and nasal polyposis. We are also surprised that no mention is made of …