The skier's nose: a model of cold-induced rhinorrhea.
Cold-induced rhinorrhea (CIR) is a commonly experienced discomfort not previously addressed in the medical literature. In a 2-part study, we assessed the prevalence and described the characteristics of CIR and evaluated the efficacy of an anticholinergic nasal spray in its treatment. In Part 1, 90 general medical patients at a ski resort clinic were asked to describe their symptoms associated with cold exposure. Ninety-six percent reported some degree of CIR; 48% reported moderate to severe CIR. Fifty percent had some degree of nasal congestion and 33% reported sneezing. Allergic and nonallergic patients described similar degrees of rhinorrhea. In Part 2, 14 ski patrollers were given atropine sulfate in saline (AS/S) nasal spray before cold exposure in double-blinded placebo (P) controlled crossover fashion. Ninety-two percent noted improvement of CIR with AS/S and 8% experienced no change. None of the subjects noted worsening of symptoms, however, one subject reported excessive dryness at the AS/S concentration used. All 14 subjects receiving P experienced no change in CIR. We conclude that CIR is a distinct clinical syndrome frequently seen with cold temperature exposure, presenting primarily as rhinorrhea and sometimes involving nasal congestion and sneezing. Pretreatment with a 0.005% solution AS/S can effectively block CIR with only minimal short-term side effects.
Silvers
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WS
Asthma, Allergy and Immunology Clinic of Colorado, Englewood.
D000281:Administration, Intranasal; D001285:Atropine / Q000008:administration & dosage / Q000592:standards / Q000627:therapeutic use; D003080:Cold Temperature / Q000009:adverse effects*; D004311:Double-Blind Method; D006801:Humans; D009297:Nasal Mucosa / Q000378:metabolism / Q000473:pathology; D010276:Parasympatholytics / Q000008:administration & dosage / Q000592:standards / Q000627:therapeutic use; D015995:Prevalence; D012220:Rhinitis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012865:Skiing; D013577:Syndrome
D010276:Parasympatholytics; D001285:Atropine