The correct choice of treatment for chronic rhinitis Chronic rhinitis refers to chronic inflammation of the mucosa and submucosa of the nasal cavity and is divided into chronic simple rhinitis and chronic hypertrophic rhinitis. Chronic simple rhinitis, mainly manifested as intermittent and alternating nasal congestion, is the most common; chronic hypertrophic rhinitis, with persistent and progressive nasal congestion as the main feature, is less common. The causes of chronic rhinitis are many. The common factors are: 1 acute rhinitis course delayed: acute upper respiratory tract infection (cold) is not completely treated, the nasal mucosa lesions are not fully recovered, the course of the disease is delayed, the formation of chronic rhinitis. 2
The nasal cavity and sinus lesions: nasal septum deviation or crest, obstructing nasal ventilation and drainage, causing chronic inflammation of the nasal mucosa; sinus inflammation, sinus secretions discharged into the nasal cavity, stimulating the nasal mucosa, causing chronic inflammation of the nasal mucosa. 3 adjacent organ lesions: such as chronic tonsillitis, adenoid hypertrophy, easily lead to the upper respiratory tract in a state of chronic inflammation, resulting in chronic rhinitis. 4, occupational environmental factors: such as harmful gases or dust stimulation, changes in temperature and humidity, especially cold and humid environments, can lead to the disease. 5, systemic factors: many chronic diseases, long-term constipation, malnutrition, endocrine disorders, addiction to alcohol and tobacco, as well as immune dysfunction and allergic reactions, also related to the disease. 6, other factors: nasal medication improper or for too long, especially the long-term use of decongestants, easy to form drug rhinitis. The chronic simple rhinitis nasal vascular and neural regulation dysfunction, vascular loss of contraction capacity, especially the inferior turbinate submucosa spongy tissue is chronically dilated, resulting in turbinate enlargement, nasal obstruction; glandular secretion active, increased nasal discharge. If the lesion develops further, there will be limited or diffuse submucosal fibrous tissue hyperplasia, local microcirculation obstruction, or even lead to hyperplasia of nasal turbinate periosteum and bone, making the turbinate harden and lose elasticity. The main symptom of chronic rhinitis is nasal congestion, which is mainly caused by enlarged turbinates. Simple rhinitis is characterized by intermittent, alternating nasal congestion. It is obvious when it is cold or quiet, and the nasal congestion is obvious in the lower nasal cavity when lying on the side; the symptoms are reduced or disappear when it is warm or after exercise. Chronic hypertrophic rhinitis is characterized by persistent nasal congestion with gradual aggravation. Patients have bilateral nasal congestion, which is sometimes mild and sometimes severe, but rarely has a clear passage. It is also manifested by increased nasal secretions. Simple and hypertrophic rhinitis both show increased secretions, mostly white mucus, or slightly yellow, or a small amount of clear mucus. In some patients, the secretions flow backwards and are spit out from the mouth through the nasopharynx, which is manifested as “polyphlegm”. In some patients, there is also an impaired sense of smell, nasal sound in speech, headache and dizziness. Local examination, simple rhinitis mucous membrane congestion, turbinate enlargement, smooth surface, nasal cavity after the use of 1% ephedrine, good contraction, indicating that the turbinate submucosa tissue without pathological hyperplasia. In hypertrophic rhinitis with drug rhinitis, the turbinates are hypertrophic, the surface is not smooth, mulberry-shaped, insensitive to 1% ephedrine, and basically do not contract, indicating hyperplasia and hypertrophy of the submucosal tissue of the turbinates. The long duration of the disease can further lead to hyperplasia of the bones of the turbinates as well. Different treatments should be chosen for these two types of rhinitis. The main pathological changes in simple rhinitis are the dysfunction of the blood vessels and nerves in the mucosal tissue of the turbinates and the dysfunction of the secretory glands under the mucosal tissue, but the contraction function of the mucosal tissue of the turbinates is still in a normal or basically normal state, so the main treatment should be conservative, and the function of the blood vessels, nerves and glands in the nasal cavity should be restored to normal through drugs. Western medicine has less cure for chronic rhinitis, and its conservative therapy is not ideal, while Chinese medicine is more effective, so simple rhinitis is the dominant disease in Chinese medicine. The treatment is based on the identification and treatment of Chinese medicine, injection of Chinese medicine into the inferior turbinate, acupuncture point compress, Chinese medicine rinse nasal cavity and other therapies can obtain satisfactory results. Hypertrophic rhinitis is mainly due to the hyperplasia and hypertrophy of the submucous tissue of the nose, and the contraction function of the mucous membrane of the turbinates is severely reduced, with persistent nasal congestion as the main cause. In this case, the course of Chinese medicine treatment is long, and some patients do not have obvious results, so surgery can be considered. The main surgical methods for chronic rhinitis are partial inferior turbinate resection and minimally invasive procedures such as low-temperature plasma ablation, laser and microwave. Mastering the indications for surgery is the first step to ensure the success of surgery. If the indications for surgery are expanded at will, it will easily lead to postoperative complications. Simple rhinitis is a non-surgical indication, and if a patient with simple rhinitis undergoes surgery, he or she is highly susceptible to postoperative complications. The most common one is atrophic rhinitis, or “empty nose syndrome”. The most common complication is atrophic rhinitis, or “empty nose syndrome,” which is caused by excessive damage to the nasal mucosa and small turbinates, resulting in hyperventilation, nasal discomfort, dryness, and nasal pain or headache. Due to the heavy destruction of nasal mucosal tissue and impaired glandular function, the nasal cavity is dry and less fluid, or a large amount of dry crust is visible. For simple rhinitis, conservative treatment is recommended. For hypertrophic rhinitis, systematic conservative treatment is recommended for 1~3 months, and surgery is considered for those with poor results. We strive to minimize the chance of surgical complications.