10-minute consultation: Rhinitis

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7347.1219/a (Published 18 May 2002) Cite this as: BMJ 2002;324:1219

Referral to specialist otolaryngologist may be advisable

  1. Natalie Brookes (Nataliebrookes@aol.com), specialist registrar,
  2. Hesham Saleh, consultant surgeon,
  3. Ian Mackay, consultant surgeon
  1. Department of Otorhinolaryngology, Charing Cross Hospital, London W6 8RF
  2. Frimley Park Hospital, Camberley, Surrey GU16 5UJ

    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 …

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