I. Congenital developmental malformations: 1. Congenital posterior nostril atresia: can occur unilaterally or bilaterally, incomplete or complete, bony, membranous or mixed. Unilateral, incomplete atresia can have no characteristic manifestations and is not detected until adulthood; bilateral complete atresia in newborns can have periodic dyspnea (dyspnea when quiet, relieved or disappeared when crying), perilabial cyanosis and other signs of hypoxia, inability to suckle, difficulty in breastfeeding, and even death by asphyxia soon after birth.
2. Congenital pear-shaped foramen stenosis: It is rare, and there are only case reports of patients with bony anterior nostrils in the form of cleft and narrow nasal valve area.
2. Acute rhinitis and sinusitis: It can be caused by viral infection of common cold, also seen in the prodromal phase of some acute infectious diseases (such as influenza, measles, scarlet fever, whooping cough, etc.), patients have fever, sneezing, runny nose (initially clear, gradually becoming mucous and mucopurulent), bilateral nasal congestion, headache and general tenderness, examination shows nasal mucosa congestion, inferior turbinate edema, nasal tract accumulation of clear or pus, can It can be accompanied by nasal vestibulitis. Generally, the course of the disease is about 7~10d after the symptoms gradually reduce and disappear. If improperly treated or affected by other factors, the inflammation can be prolonged and become chronic.
Chronic rhinitis, sinusitis: 1, chronic simple rhinitis: and inferior turbinate vasodilatation dysfunction caused by the typical symptoms are alternating nasal congestion, nasal obstruction in the lower when lying on the side, the upper gradually ventilated, double inferior turbinate enlargement, smooth surface, soft and elastic when the probe is palpated, after exercise or spray decongestant inferior turbinate contraction is good, ventilation quickly improved.
2.Chronic hypertrophic rhinitis: the inferior turbinate is proliferated and hypertrophied, causing unilateral or bilateral persistent nasal congestion, its surface is not smooth, mulberry or nodular, hard and inelastic when palpated, and does not respond well to decongestants.
3, atrophic rhinitis: can be caused by dry crust blockage nasal congestion, can be reduced after cleaning, can also be due to atrophy of nasal mucosa sensory nerve endings degeneration, sensory dullness, although there is airflow in and out of the nasal cavity, but patients still feel nasal congestion, that is, “sensory nasal congestion”, the presence of nasal airflow can be measured with the anterior nasal manometer.
4, drug rhinitis: long-term use of nasal decongestants caused by the double inferior turbinate enlarged, hard, dark red, spray decongestants after the inferior turbinate does not shrink, and even increased, spray glucocorticoid preparations can make its persistent nasal congestion temporarily reduced.
5, allergic rhinitis: its nasal congestion is characterized by rapid appearance and disappearance, with sudden, paroxysmal characteristics, mostly in the morning, when contact with pollutants, allergens, rapid emergence of nasal itching, sneezing, clear water-like snot and double nasal congestion, examination of the nasal mucosa is mostly pale, blue-purple, edema, nasal tract accumulation of clear water-like snot. Patients mostly have family history and history of skin and drug allergy, about 1/3 patients have asthma, increased eosinophils in nasal secretions and blood, positive allergen skin test or nasal excitation test, and increased amount of specific IgE in serum and nasal secretions.
6, vasomotor rhinitis: clinical manifestations similar to allergic rhinitis, but no eosinophilia, allergen test negative.
7, chronic sinusitis: purulent secretions from the sinuses into the nasal cavity, irritating the mucous membrane, causing turbinate enlargement and nasal congestion.
Fourth, nasal foreign body is mostly seen in children causing unilateral nasal congestion, and foreign body can be seen in the common nasal passage after careful contraction of inferior turbinate. Nasal calculi mostly occur in patients with small foreign bodies stored in the nasal cavity, with foreign bodies as the core and salt deposits formed.
V. Nasal trauma, post-surgery resulting in nasal bone fracture, nasal bridge collapse, narrowing of the anterior nostril, scar atresia, nasal adhesions or deviated nasal septum, etc.
Sixth, nasal septal deviation, spine and crest can trigger unilateral nasal congestion and headache, and septal hematoma and abscess are mostly bilateral nasal congestion.
VII. Special infectious granulomas or scar adhesions in the nasal cavity.
Such as nasal diphtheria, tuberculosis, syphilis, sclerosis, leprosy, etc., whose nasal congestion is mostly insidious onset, slowly aggravated, often accompanied by special odor and blood-tinged discharge. Laboratory tests, X-ray chest film, pathological examination can help to confirm the diagnosis.
Eight, adenoid hypertrophy, infection, nasopharyngeal neoplasm such as congenital epidermoid cyst, polyp in the posterior orifice of maxillary sinus, angiofibroma, nasopharyngeal cancer, etc. It can cause single or double nasal congestion. Adenoid hypertrophy is mostly seen in children under 10 years old, often accompanied by adenoid face, and nasopharyngeal mass shadows can be seen on cranial lateral X-ray; angiofibroma is mostly seen in male adolescents, with a history of repeated massive nasal bleeding; nasopharyngeal carcinoma is occasionally mass-shaped and can cause nasal congestion.
Nine, nasal polyps, congenital intranasal type meningeal brain expansion, papilloma, hemangioma, nasal and sinus malignant tumors.
They can manifest as progressive nasal congestion, and each has certain characteristics on nasal examination. Imaging examination is helpful to confirm the diagnosis.
Ten, systemic diseases such as hypothyroidism, diabetes, pregnancy, hypertensive patients taking antihypertensive drugs, often accompanied by inferior turbinate enlargement and cause nasal congestion.