The doctor in the office often heard complaints from patients that the nose was not breathing. If this problem worries not only during colds, then perhaps there is a hypertrophic chronic rhinitis. People realize the seriousness of this problem, as a rule, when it is not possible to breathe through the nose. Other signs of the disease may appear. Next, we consider what symptoms are typical for this pathology, as well as methods of therapy and prevention.
What does this disease mean?
Chronic hypertrophic rhinitis (ICD-10 code J31.0.) Is an inflammation of the mucous membranes of the nasal cavity, during which they grow. This process has several steps:
- First step. The ciliary epithelium is slightly affected. The mucous membranes are inflamed. Surrounding tissue is not damaged.
- Second phase. Glandular tissues and ciliary epithelium are affected. The inflammatory process extends to the walls of blood vessels and muscle fibers. Because of this, the lymphatic and blood vessels begin to squeeze.
- The third stage. Swelling is increasing. Symptoms are pronounced. The ciliary epithelium is affected, as well as glandular and mucous tissues. Damaged vessels. The inflammatory process can affect bone tissue. At this stage, not without surgical intervention.
Varieties of pathology
Hypertrophic chronic rhinitis can be classified according to the prevalence of the process and pathomorphological signs.
By prevalence:
- Diffuse. Uniform increase in the volume of the nasal concha.
- Limited.
By pathomorphological signs:
- Cavernous form. Most often diffuse in prevalence.
- Fibrous form. It can be either diffuse or limited. It progresses slowly, but the changes are irreversible.
- Bone hypertrophy. Thickening and proliferation of the nasal mucosa. It can take tuberous, uneven, pineal forms.
The following factors have a significant impact on the development of pathology:
- The presence of a chronic inflammatory process.
- Disruption of capillary circulation in the tissues.
- Oxygen starvation of tissues and metabolic disorders in them.
- A significant decrease in local immunity.
- Activation of saprophytic bacteria.
Causes of the disease
What can provoke a disease such as hypertrophic chronic rhinitis?
The reasons may be as follows:
- Uncontrolled use of local vasoconstrictor drugs.
- Frequent infectious diseases of ENT organs.
- Untreated rhinitis.
- Chronic allergic rhinitis and the absence of any treatment.
- Disruption of the endocrine system.
- The presence of cardiovascular disease.
- Hereditary predisposition.
- Curvature of the nasal septum, whether it is a congenital pathology or acquired.
- Pathology of the neuro-reflex function of the nose.
- Bad habits, especially smoking and inhaling fumes of psychotropic substances.
- Work in hazardous work and living in an overly polluted area. Vapors from harmful industries, radiation, and too dry and dusty air can cause diseases of the ENT organs.
- Decreased body resistance.
Symptoms of chronic hypertrophic rhinitis
Hypertrophic chronic rhinitis symptoms will be similar to an allergic or infectious form of the disease, but will also have its own characteristics.
Symptoms will be as follows:
- Mucous discharge from the nose. However, they do not have color and odor, but can have purulent impurities.
- The nose is blocked, breathing is difficult. At the same time, vasoconstrictor drops do not help.
- Headache.
- Nervous excitability.
- Trouble sleeping.
- Chronic fatigue.
- Odor recognition is gradually deteriorating.
- Heaviness in the head.
- A man speaks through his nose.
- Lacrimation, redness and swelling of the eyelids.
- Conjunctivitis.
Signs and possible complications of chronic hypertrophic rhinitis in children
Children are more susceptible to infections, as the body is only being formed, therefore, signs of chronic hypertrophic rhinitis will have more pronounced signs that can affect the health of the child in the future.
We highlight several signs characteristic of children:
- The child breathes through the mouth, breathing is difficult.
- Headache.
- It gets tired quickly.
- Hearing loss.
- Lack of smell.
- The nasal voice.
- Decrease in school performance.
- Poor attention span.
What are the possible complications for a child with this disease:
- Significant impact on the psychomotor development of the child, the success of training.
- It provokes frequent otitis media, sinusitis, bronchial asthma, pneumonia.
To avoid the transition of rhinitis to chronic hypertrophic, it is necessary to adhere to the doctor's recommendations in therapy and treat infectious diseases in children in a timely manner. It is important to conduct tempering procedures, maintain optimal indoor temperature, conduct preventive vitaminization, and often walk in the fresh air.
Diagnostics
First of all, you need to contact a specialist otolaryngologist.
In order to diagnose a disease such as hypertrophic chronic rhinitis, symptoms alone are not enough for a doctor. Modern examination methods are applied.
How is the examination:
- The doctor finds out the nature and duration of the disease, how the symptoms developed and what treatment was carried out.
- The nasal cavity is examined. Rhinoscopy is performed.
- Rhinopneumometry is used to test the functionality of the nasal cavity.
It is also necessary to pass the following tests:
- General blood analysis.
- Eosinophils.
- Immunoglobulin E in the blood.
Additional research:
- Roentgenography.
- Computed tomography of the sinuses of the nose.
Medical treatments
In order to alleviate the patient’s condition with a diagnosis of chronic hypertrophic rhinitis, treatment may include the following medical procedures:
- In the initial stages of the disease, rinsing with saline solutions of the nasal cavity is prescribed.
- With a strong hypertrophic process, cauterization with trichloroacetic acid or chromic is prescribed, as well as Lapis. Before the procedure, an anesthetic injection is made.
- In case of violations of the mucous membrane, Hydrocortisone is prescribed.
- The drug "Splenin" is prescribed in the form of injections and is administered intradermally or as an ointment, then it is applied to the mucous membranes with massage movements.
Medication methods cannot cope with structural changes in the nasal membranes, but can alleviate the patient’s condition for a while and stop the thickening of epithelial tissues.
Recommended physiotherapeutic procedures
If the process of hypertrophy of the nasal membranes is poorly expressed, the doctor may recommend the following physiotherapeutic procedures together with drug therapy:
- UHF
- Massage the mucous membranes using ointments.
- Ultraviolet irradiation of nasal shells.
But when medical methods of treatment in combination with physiotherapeutic procedures were not effective during the treatment of such a disease, it is necessary to use an operational method of getting rid of pathology.
Surgical Treatment
If the growth of the mucous membrane and the hypertrophic process are not stopped, and chronic hypertrophic rhinitis continues to develop, treatment is impossible without surgical intervention.
What types of surgical intervention can be:
- In the early stages, with a cavernous form, laser submucosal vasotomy can be offered. Remove the vessels under the nasal mucosa.
- Electroplating method. It will be necessary to use anesthesia, as tissue is cauterized by electric current.
- The method of ultrasonic disintegration of the nasal cavity. It is bloodless, but requires pain relief. It consists in the destruction of the nasal concha with the help of a special surgical plug, to which an electric current is supplied.
- Method conhotomy. The mucosa is removed in some areas of the nasal concha. It can be carried out in different variations:
- Laser conchotomy. This is a bloodless option.
- Total conchotomy.
- Partial conchotomy.
- Method of cryodestruction. Assumes the use of liquid nitrogen. There is an effect on hypertrophic areas with a special cryoapplicator.
Do not be afraid of surgery, it is performed using general or local anesthesia, if the diagnosis of chronic hypertrophic rhinitis is confirmed. The operation will take 20-30 minutes thanks to modern endoscopic equipment. On the third day, the patient can return to their usual lifestyle.
Alternative methods of treatment
If the disease appears at an early stage, you can try alternative methods of treatment.
But first of all, you need to consult a doctor about the use of herbs.
Here are some ways:
- Saline solution with the addition of iodine for washing the nasal cavity.
- Use of essential oils for steam inhalation. Apply lavender, tea tree, lemongrass.
- Washing the nasal cavity with decoctions of herbs: sage, chamomile, mint, St. John's wort, plantain.
- Drops in the nose from garden lice or from a decoction of St. John's wort and plantain.
Possible complications of the disease and treatment prognosis
Hypertrophic chronic rhinitis progresses slowly and can last for many years. And if the disease is not treated, then it will give the following complications:
- Sinusitis
- Adenoiditis
- Tonsillitis.
- Tracheobronchitis.
- Conjunctivitis.
- Acute or chronic form of eustachitis and tubootitis.
- Inflammatory diseases of the lower respiratory tract.
- Disruption of the digestive system.
- Disruption of the cardiovascular system.
Due to impaired breathing, the normal functioning of the body is disrupted. It is necessary to treat chronic hypertrophic rhinitis in the early stages, so as not to resort to surgery. If the process is not ignored for many years, but treated in a timely manner, then the prognosis is favorable, provided that complications do not have time to appear.
So that a common cold does not develop into hypertrophic chronic rhinitis, prevention should be carried out, especially in people who have a hereditary predisposition. The doctor will give the necessary recommendations.
Preventative measures
It is necessary strictly under the supervision of a doctor to treat a disease such as hypertrophic chronic rhinitis. We examined the symptoms and treatment earlier, but you also need to know what preventative measures exist.
We list a few recommendations that can be considered preventive measures:
- Timely and effective treatment of all nasal diseases.
- In hazardous, dusty and gas-polluted industries, personal protective equipment, such as masks or respirators, must be used.
- Avoid very dusty and gassed rooms.
- If you are allergic to any drugs or substances, you should avoid contact with them and take antihistamines in a timely manner.
- Try to exclude allergens in food and contact with them at home.
- Timely treat inflammatory diseases of the ENT organs.
- Hardening procedures are recommended.
- Walks in the open air.
- Sunbathing.
- Strengthen the immune system.
- Get rid of bad habits.
- Do not supercool.
Young people often ask themselves: “Does chronic hypertrophic rhinitis and the army have compatibility?” It is worth noting that with this diagnosis, the young man is fit for military service. He may not be drafted into the armed forces in the event that a fetid runny nose is expressed, purulent or polypous sinusitis occurs with frequent exacerbations and with persistent violation of nasal breathing.