Rhinitis medicamentosa as a cause of increased intraoperative bleeding.

Rhinitis medicamentosa occurs with repeated and prolonged use of topical decongestants. The resultant reduced ability to respond to decongestants mediated via enlarged capillary endothelial gaps can lead to profuse bleeding during turbinate surgery. We recommend that patients with rhinitis medicamentosa be weaned off topical decongestants prior to elective turbinate surgery to minimize this complication. The management of rhinitis medicamentosa and a case of intraoperative hemorrhage are presented.