Neurovegetative rhinitis is a chronic disease of the nasal cavity. By its name, it can be determined that the causes of the occurrence are disturbances in the nervous regulation of the mucous membrane. This ailment is accompanied by poor breathing and profuse serous secretions. At the same time, during the examination, it is not possible to identify any characteristic inflammatory changes. With the help of vasoconstrictor drugs, doctors manage to relieve symptoms, but it is possible to completely cure the disease by acting on the nervous system.
Classification
It is worth recognizing that the classification of neurovegetative rhinitis is currently somewhat difficult. There are a large number of morphological changes, pathogenesis, and etiology that make this task difficult for all types of chronic rhinitis.
At the same time, we can say with confidence that it is a form of vasomotor rhinitis. With a neuro-vegetative form, the disease is functional in nature, there are no signs of inflammation of the mucous membrane.
Doctors distinguish two types of vasomotor rhinitis: vasomotor rhinitis of a neurovegetative form and an allergic type.
False rhinitis
It is noteworthy that some researchers even attribute them to “false rhinitis”, since they are not characterized by the accumulation of purulent exudate and the destruction of cell complexes of the patient’s mucosa.
A key influence on the development of this ailment is exerted by problems with nervous regulation. At this time, the vascular network expands as much as possible, contributing to tissue edema, and breathing is impaired due to this. Often in such patients, hypotension, dystonia, bradycardia can be detected.
Causes
Neurovegetative rhinitis appears against the background of disorders that occur in the nervous system. The fact is that the center of nervous regulation, which is responsible for the effect on the mucous membrane and vascular wall of the nose, is located in the hypothalamus. It is strongly influenced by many external conditions - overwork, stress, hypotension. As a result, breathing may be difficult.
Among the most common causes of the neurovegetative form of rhinitis are the following:
- thyroid disease (autoimmune thyroiditis, hypothyroidism);
- functional disorders of the brain (neurocircular or vegetovascular dystonia, neurosis);
- regular contact with dust at work or at home for a long time;
- prolonged use of vasoconstrictor drops;
- regular stay in cold air;
- ridges or polyps of the nasal concha, curvature of the nasal septum.
The main reason for this is the reaction of blood vessels in response to a specific stimulus. As a result, they begin to expand, and the wall of the mucous membrane becomes thicker. And the microcirculation of the blood is disturbed. Cells begin to respond in response to copious secretion of mucus, the volume of the nasal concha is significantly reduced.
In most cases, such a clinical picture is observed only in one half of the nose. From time to time, it can move to another nostril.
Signs
Knowing the symptoms of neurovegetative rhinitis will help to quickly recognize this disease and begin effective and timely treatment. It should be noted that according to the clinical picture, almost all types of vasomotor ailments are similar to each other.
In this case, neurovegetative rhinitis is characterized by attacks of severe sneezing, difficulty breathing through the nose, copious discharge, a sensation of itching and burning.
Perhaps the main feature of the form of this disease is the periodic nature of the symptoms. They appear in the morning, as soon as a person wakes up. This indicates that the work of the nervous autonomic system is impaired. Symptoms may intensify due to overwork, prolonged exposure to frost, emotional stress.
As a rule, initially patients complain of congestion of only one half of the nose, the second they can breathe completely freely. At the same time, during a change in the position of the head or as a result of prolonged static stress, the symptoms return again. Such manifestations most often occur in patients with hypotension, neurocircular dystonia, and neurosis. In this case, contact a neurologist for help.
Seasonality is unusual for this type of rhinitis. Symptoms may occur at any time of the year. This neurovegetative form is different from allergic. The influence of pathological factors leads to hypertrophy of the mucous membrane and the regular appearance of symptoms. As a result, polyps may appear in the nose, which will require surgical intervention to remove them.
Diagnostics
Complaints with neurovegetative rhinitis of a runny nose and nasal congestion appear in healthy people who have no other signs of a cold or infection. Therefore, they pay attention to a stuffy nose only when it begins to seriously interfere with work or sleep. With such problems, you should first contact an otolaryngologist.
The doctor conducts a number of studies that allow you to establish an accurate diagnosis. These are anterior rhinoscopy, analysis of nasal mucus, rhinomanometry, radiography and SKT of the facial skull.
Consultation with a neurologist and a general blood test should also be added to the diagnostic measures. If eosinophilia is found in the results, then this is more characteristic of allergic rhinitis. Patients with a neurovegetative form of the disease should receive further treatment from a neurologist. The disease should be given close attention, since it can be accompanied by VVD, lability of the nervous system and other concomitant diseases.
Treatment
During the treatment of neurovegetative rhinitis, the main task is to eliminate provoking factors. As a rule, they are associated with the nervous system and have a reflex nature. Sound sleep, normalization of the work schedule, morning exercises, minimization of stressful situations, strengthening the tone of the autonomic nervous system can significantly alleviate the patient’s condition. In combination, all these factors affect the functioning of the brain and can facilitate nasal breathing.
Certain drugs should be taken with acute attacks of neurovegetative vasomotor rhinitis. Treatment with drugs from the group of alpha-adrenergic agonists in this situation seems to be the most preferable. They are able to sharply narrow vessels, reduce the amount of secretions of the mucous exudate and relieve swelling.
Dosage
If we talk about specific drugs, then the drops and sprays “Fornos”, “Galazolin”, “Nazivin”, “Otrivin”, “Lazolvan” are considered the most effective.
If the acute phase occurs, two to three drops three times a day should be instilled into each nostril. If this is a spray, then one or two injections three to four times a day are enough.
In the treatment of neurovegetative vasomotor rhinitis with these agents, one should be careful, as long-term use helps to reduce their effectiveness, addiction, atrophy of the nasal mucosa, regular bleeding.
Taking antihistamines
There are also antihistamines that reduce vascular conduction, eliminate edema, while maintaining their tone, slowing down the secretion of inflammatory mediators. Among this group of medicines, Telfast, Erius, and Trexil should be distinguished.
In most cases, they are used one tablet in the morning. The course of treatment is agreed with the doctor. It can reach one month, before taking the drugs again, a break of 10-14 days should be taken. These medications do not have sedative properties, do not affect heart function and reaction rate.
General strengthening procedures
According to patients who have encountered such problems, these methods demonstrate high efficiency in any neuro-vegetative disorders.
For example, doctors recommend taking an electrophoresis course on the collar zone, taking a contrast shower, attending massage sessions, and tempering. All this contributes to the expansion of the vessels of the neck, improve the conductivity of nerve impulses and the blood supply to the brain, normalize the functions of cell membrane complexes.
For local use, laser radiation is used at low frequencies, as well as exposure to the mucous membrane with a magnetic field. Outside, radiation is projected onto the base of the nose, and from the inside onto the nasal concha.
Surgical method
Surgical treatment is used only in cases of crests, polyps and nasal septum spines. Because of this, the nerve regulation of mucinous cells and blood vessels is disturbed.
In this situation, in these areas there is a decrease in the volume of inhaled air due to vasodilation and swelling of the mucosa. Therefore, in the surgical treatment of neurovegetative vasomotor rhinitis, it is required to burn out additional formations using a coagulator or laser radiation.
Complications
Although this type of rhinitis is not accompanied by inflammatory formations, it must be treated, as otherwise it is fraught with serious complications. They appear with the most pronounced symptoms. For example, polyps can form in the septum and nasal concha, which overlap the openings of the sinuses and the nasal passage itself. In this situation, surgical treatment consists in removing the polyp as a result of a surgical operation.
Against the background of the prolonged course of one of the types of vasomotor rhinitis, sinusitis or purulent frontitis can occur. Mucosal edema leads to the accumulation of viscous exudate, which interferes with its natural removal. In this case, there is a danger of the bacterial flora joining and the formation of pus in the paranasal sinuses. Patients begin to complain of headaches, purulent discharge from the nose, and high fever.
In such a situation, urgent treatment should be started. For this, a puncture of the paranasal sinus is performed, and after the sinuses are washed with antiseptics, antibiotics are prescribed.
Folk remedies
In some cases, the use of folk remedies is effective. Kalanchoe juice is instilled into the nose or turunds soaked in beetroot juice are inserted.
It is advised to lubricate the nose with an ointment based on calendula, diluted in half with petroleum jelly. Fir oil also helps in combination with a massage of the nose and nose wings.