Head & Neck
17 cases on guideline-threshold combination therapy in allergic rhinitis, local and nonallergic rhinitis phenotypes, rhinitis medicamentosa, rhinitis in pregnancy, the unified-airway model, montelukast’s boxed warning, biologic-versus-revision-surgery thresholds in CRSwNP, macrolide therapy in chronic rhinosinusitis, allergic fungal sinusitis, AERD, acute rhinosinusitis against an untreated allergic baseline, senile rhinitis and anticholinergic burden, pediatric growth-suppression risk, allergic conjunctivitis, vernal keratoconjunctivitis, and SCIT-versus-SLIT immunotherapy selection — choose a case below to open its full multi-voice debate.
A congestion-dominant allergic rhinitis case tests whether a guideline severity threshold or an uncorrected nasal-spray technique error should drive the next therapeutic step.
Six years of nasal symptoms, a negative systemic allergy workup, and a positive nasal allergen challenge raise whether immunotherapy is defensible without systemic IgE evidence.
A chef's reproducible, food-triggered rhinorrhea raises whether a mechanistically clear nonallergic phenotype justifies skipping the usual antihistamine/steroid trial.
A musician's oxymetazoline-induced rebound congestion tests whether an oral steroid burst or a trial-backed topical bridge is the better route to functional recovery before a deadline.
A second-trimester patient's request for pseudoephedrine tests whether a gastroschisis signal tied to first-trimester exposure still applies once that window has closed.
Two asthma patients with untreated allergic rhinitis test whether the unified-airway model changes management only when asthma control has already stalled.
A child's sensory aversion to nasal sprays makes montelukast the only convenient option left, testing how the 2020 boxed warning should weigh against a genuine access barrier.
Recurrent nasal polyps after prior sinus surgery raise whether a biologic matching the patient's trial-population profile should be tried before a second operation.
A negative randomized macrolide trial in chronic rhinosinusitis sits against an earlier trial's low-IgE subgroup signal, testing whether that phenotype changes the calculus.
Recurrence risk in allergic fungal sinusitis raises whether oral itraconazole's case-series evidence justifies real toxicity monitoring alongside a trial-supported steroid taper.
Two AERD patients with the same disease diverge on treatment once one already needs daily aspirin for his heart and the other has no reason to accept its risks.
A double-worsening symptom pattern meets IDSA's own criteria for bacterial sinusitis, but an entirely untreated allergic baseline complicates what the trial evidence actually supports.
An 83-year-old's idiopathic rhinorrhea responds mechanistically to a topical anticholinergic, testing whether it meaningfully adds to a burden score built around systemic drugs.
A parent's internet-driven growth concern about a child's daily nasal steroid turns out to track a real, agent-specific difference in the pediatric growth-velocity literature.
Severe seasonal allergic conjunctivitis inadequately controlled on a topical antihistamine raises how much caution a genuinely lower-risk soft steroid still deserves.
A fourth consecutive spring of vernal keratoconjunctivitis raises whether a steroid-sparing calcineurin inhibitor should replace another corticosteroid course in a growing child.
A patient ready to escalate beyond pharmacotherapy weighs SCIT's broader trial evidence and office-visit burden against SLIT's convenience and documented lower real-world persistence.