Chronic rhinitis is a chronic inflammatory disease of the submucosal tissue of the nasal cavity. It is characterized by clinical manifestations of swelling, hyperplasia and hypertrophy of the nasal mucosa, increased secretions, no clear pathogenic microbial infection, and a course lasting more than a few months or recurrent episodes.
I. Etiology: It is generally believed that this disease is not an infectious disease, and even if infection exists, it is secondary. At present, it is believed that the disease is associated with many factors.
1, local factors
(1) Repeated attacks of acute rhinitis or incomplete treatment, which is delayed into chronic inflammation.
(2) Anatomical variation of the nasal cavity, such as deviation of the nasal septum or pneumatization of the middle turbinate, obstructs nasal ventilation and drainage and increases the chance of recurrent infection of the nasal mucosa, leading to persistent and chronic inflammation of the nasal mucosa.
(3) Sinus chronic inflammatory diseases such as chronic sinusitis, nasal secretions in the nasal cavity long-term stimulation of the nasal mucosa, resulting in the persistence of inflammation, which in turn aggravates sinusitis, rhinitis and sinusitis of this persistent mutual causal interaction, forming a vicious circle.
(4) adjacent foci of infection such as chronic tonsillitis, adenoid hypertrophy and other inflammatory conditions continue to cause the presence of inflammation of the nasal mucosa.
(5) inappropriate or prolonged nasal medication such as naphthazoline or ephedrine abuse in the nasal cavity causes drug rhinitis.
2, occupational and environmental factors: long-term or repeated inhalation of dust (such as cement, lime, coal dust, flour, etc.) or harmful chemical gases (such as sulfur dioxide, formaldehyde, etc.), life or rapid changes in humidity and temperature in the environment (such as steelmaking, baking and melting, freezing operations) can cause this disease.
3.Systemic factors
(1) systemic chronic diseases such as anemia, diabetes, rheumatism, tuberculosis, heart, liver and kidney diseases, plant nervous disorders and chronic constipation, etc., can cause long-term stasis or reflex congestion of the nasal mucosa blood vessels.
(2) Malnutrition Vitamin A and C deficiency.
(3) Endocrine diseases or disorders such as hypothyroidism can cause edema of the service mucosa. In late pregnancy and adolescence, the nasal mucosa is often physiologically congested and swollen.
4, other factors tobacco and alcohol addiction, long-term overwork, immune dysfunction, allergic rhinitis.
Clinical classification: Chronic simple rhinitis and chronic hypertrophic rhinitis
(1) Chronic simple rhinitis is characterized by intermittent, alternating nasal congestion, which is aggravated at night, when sitting still, when cold, and alleviated during the day, in summer, when active, with nasal congestion on the left side when lying on the left side, and on the right side when sleeping on the right side. There is more nasal discharge, mostly mucous thin nasal discharge, accompanied by pus discharge in case of infection. It may be accompanied by headache, dizziness, dry throat, sore throat and heavy nasal sound, decreased sense of smell, tinnitus and ear blockage.
(2) Chronic hypertrophic rhinitis Unilateral or bilateral persistent nasal congestion without alternation, sticky mucus or purulent nasal discharge, not much volume, not easy to blow out. It is often accompanied by heavier nasal sound, tinnitus, ear blockage feeling, and may be accompanied by headache, dizziness, dry throat, sore throat and decreased sense of smell.
It should be noted here that there is no strict and clear line of demarcation between chronic simple rhinitis and chronic hypertrophic rhinitis, and most patients fall in between, either favoring the former or the latter. The former can develop and transform into the latter. The clinical symptoms of the two are slightly different, and the treatment differs.
Second, the principle of treatment: eradicate the cause, restore the nasal ventilation function
1. Chronic simple rhinitis
(1) Etiological treatment Find out the all-round and local causes, and treat systemic and local chronic diseases, such as sinusitis and deviated nasal septum, in a timely manner. Improve the living and working environment, exercise and improve the body resistance.
(2) Topical treatment
(1) Intranasal glucocorticoids, which have good anti-inflammatory effects, not only reduce the edema and congestion of nasal mucosa, prevent the thickening and continued thickening of nasal mucosa, but even make the hypertrophic mucosa less hypertrophic, and have more desirable effects on improving nasal congestion and other symptoms in the near and long term.
② Nasal washing For those who have more nasal secretions, saline can be used for nasal rinsing to remove the secretions, which can improve nasal congestion and runny nose.
③ Short-term use of decongestants for nasal endoscopy can quickly contract the nasal mucosa, reduce nasal mucosal congestion and relieve nasal congestion rapidly. Such as hydroxymetazoline spray, but continuous use should not exceed 7 days, and if it is necessary to continue to use, it should be stopped for 3 to 5 days and used again. Hypertensive patients should be used with caution.
2.Chronic hypertrophic rhinitis
(1) Medication Same as chronic simple rhinitis
(2) Surgical treatment For those who are not satisfied with the effect of medication, partial excision of inferior turbinate is feasible; external displacement of inferior turbinate fracture;