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Abstract: Chronic rhinitis is a chronic inflammation of the nasal mucosa, the main pathological changes are congestion and swelling of the nasal mucosa, and the main clinical symptoms are nasal congestion and nasal runny nose, which are particularly prone to recurrent attacks and a long duration of the disease. The child came to the clinic for 3 days with nasal congestion and runny nose. The child was advised to complete allergen and nasal endoscopy examinations and was diagnosed with vasomotor rhinitis.
Basic information】Female, 19 years old
Disease Type】Vasomotor rhinitis
Hospital】Northern War Zone General Hospital
Date of consultation】June 2021
Treatment plan】Conservative drug treatment (nasal spray of azelastine hydrochloride + nasal spray of tretinoin)
Treatment period】1 month of outpatient treatment
Effectiveness of treatment】The child’s nasal symptoms disappeared
I. Initial consultation
The child said that 3 days ago, after running 800 meters in a sports meeting, the child had symptoms of nasal congestion, runny nose, itchy nose and sneezing. After consultation, the child was given blood tests for allergens, skin prick test, complete nasal endoscopy and nasal secretion smear, skin prick test did not show any allergens, serum specific IgE test was negative, nasal secretion smear indicated that eosinophils were not elevated, nasal endoscopy indicated that the nasal mucosa was congested, the nasal septum was not deviated, the turbinates were not enlarged, based on the child’s current symptoms and test results, the diagnosis of vasomotor rhinitis was made, and conservative treatment with drugs was recommended.
II. Treatment
It is recommended that the child avoid contact with irritating gases, reduce alternating hot and cold air stimulation, and avoid emotional excitement. The time interval between the two drugs is 10 minutes. It is recommended to observe the regular use of medication, and the child should return to the hospital for review after half a month to decide whether to continue the medication.
Third, the effect of treatment
The child returned to the hospital after half a month for a follow-up examination and reported that the symptoms of nasal congestion and sneezing had improved significantly after 1 week of medication, but he still had occasional runny nose and itchy nose. The child’s nasal symptoms disappeared and he was very satisfied with the treatment effect, so he was asked to continue to use the medicine for half a month to consolidate the effect.
IV. Precautions
We are glad that the child’s symptoms are relieved after treatment. We suggest that the child should exercise more in his life to strengthen his resistance, but it must be moderate, increase and decrease clothing according to weather changes, wear a mask when going out to reduce the stimulation of the nasal mucosa, avoid eating spicy and stimulating food, avoid smoking and staying up late, avoid taking cold baths, avoid getting wet, avoid swimming, and reduce the stimulation of the nasal mucosa by cold water. The patient should pay attention to the personal living environment, bed sheets and covers should be cleaned diligently, do not use drugs at will, especially some nasal mucosa decongestants, long-term drug rhinitis is likely to form, more difficult to treat, during treatment is also recommended to ensure that the child is positive and optimistic attitude, more conducive to the recovery of the disease.
V. Personal insight
Vasomotor rhinitis is mainly due to autonomic dysfunction. It is recommended that the child should pay attention to environmental factors such as temperature, air pressure, and irritating gases to reduce exposure, and also pay attention to emotions to avoid excessive excitement. In addition, it is recommended that if vasomotor rhinitis occurs, it must be actively treated. Generally, the condition can be improved or even cured by controlling it with medication, and if the condition is recurrent and the medication is not effective, inferior turbinoplasty or nasal parasympathectomy can be considered.