Chronic rhinitis is a chronic inflammatory disease of the mucous membrane and submucous layer of the nasal cavity. Clinical manifestations are characterized by swelling of the nasal mucosa, increased secretions, no clear pathogenic microbial infection, and a condition that lasts for more than a few months or has recurrent episodes. Chronic rhinitis is a common disease. It can be clinically divided into two types: chronic simple rhinitis and chronic hypertrophic rhinitis.
I. Chronic simple rhinitis
(A) symptoms
1, nasal congestion is characterized by.
(1) intermittent: relieved during the day, summer, labor or exercise, aggravated at night, sitting still, cold;
(2) alternating: when changing lateral orientation, nasal obstruction on both sides alternates. The nasal obstruction in the lower position, and those in the upper position are ventilated.
2.Mucus snot is usually mucus snot, and there may be pus snot when secondary infection occurs.
3.Sometimes there may be headache, dizziness, dry throat, sore throat and other symptoms.
(B) Examination
1.The mucous membrane of nasal cavity is congested, the inferior turbinate is swollen, the surface is smooth, soft and elastic, the probe is lightly pressed into the depression, the probe is removed and immediately recovered, and it is sensitive to decongestant.
2. The secretion is sticky and mainly located in the nasal passage under the nasal cavity or the common nasal passage.
(C) treatment treatment principle: eradicate the cause and restore the nasal ventilation function.
1 etiological treatment to identify systemic and local causes, timely treatment of systemic chronic diseases, sinusitis, adjacent infected lesions and nasal septal deviation. Improve the living and working environment, exercise and improve the body resistance.
2.Local treatment
(1)Intranasal application of glucocorticoids.
(2)Saline nasal rinse.
(3) Nasal decongestants.
Chronic hypertrophic rhinitis
(A) Symptoms unilateral or bilateral persistent nasal congestion
No alternation. Not much nasal discharge, mucus or mucopurulent, not easy to blow out. There is often an occlusive nasal sound, tinnitus and a sense of ear occlusion as well as with headache, dizziness, dry throat and sore throat. A small number of patients may have hyposmia.
(II) Examination
1. The mucous membrane of the inferior turbinate is hypertrophied and the nasal turbinate bone is enlarged. The mucosal surface is uneven, nodular or mulberry-like, especially at the anterior and posterior free edges of the inferior turbinate. The probes are parenchymal and non-depressed, or depressed, but not immediately recovered. It is not sensitive to decongestants.
2. The secretion is mucous or mucopurulent, mainly found in the nasal floor and lower nasal passage.
(C) Treatment
1.The principle of drug treatment is the same as that of simple rhinitis.
2.Surgical treatment
(1) Mucosal hypertrophy and insensitivity to decongestants: submucosal partial excision of the inferior turbinate can be tried. The excision range should not exceed 1/3 of the inferior turbinate. Excessive excision may cause secondary inferior turbinate atrophy.
(2) Submucosal resection of inferior turbinate: for hypertrophy and hyperplasia of inferior turbinate bone, it can be combined with submucosal partial resection and inferior turbinate shaping at the same time to remove part of the hyperplastic and hypertrophic inferior turbinate bone that affects nasal ventilation.
(3) External displacement of inferior turbinate fracture: the whole length of the inferior turbinate is displaced to the external side to increase the cross-sectional area of nasal ventilation and improve nasal ventilation.
(4) Sinus surgery: mainly to open the septal sinus, obtain a more fixed ventilation and drainage channel, reduce the chronic irritation of the nasal mucosa by inflammatory lesions that may originate from the sinuses, and achieve the purpose of improving nasal ventilation and relieving inflammation of the nasal mucosa.
(5) Others: including laser, freezing, microwave or radiofrequency, etc., should be used with caution.