hyperreflex rhinitis
Introduction
Introduction to hyperreflexive rhinitis Hyperreflectory rhinitis (hyperreflectory rhinitis) is a highly reactive nasal disease caused by excessive reflection of local sensory nerve axons in the nose. It has been incorporated into vasomotor rhinitis in the past, and it is a "sneeze type". Now with the understanding of the neuropeptide substance P, people began to list this disease as a relatively existing type of rhinitis, Wolf (1988) called it a strong reflex nasal disease. Topical application of adrenocortical hormone and antihistamines in hypertensive reflex rhinitis is the first choice for the treatment of this disease. If the symptoms are frequent, pre-screen nerve ablation can be considered. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: rhinitis
Cause
The cause of hyperreflexive rhinitis
Sensory neuron afferent neurons belong to class C unmyelinated fibers. When retrograde stimulation of sensory nerves, SP is released at the end of class C fibers. SP is a neuropeptide of 11 amino acids that can cause local vasodilation. Increased vascular permeability and tissue edema. It was found that SP can also release histamine from mast cells. Animal experiments also found that retrograde stimulation of the trigeminal nerve intranasal sensory branch of experimental animals can lead to congestion of nasal mucosa and increased vascular permeability. And mucosal edema, if given before the animal anticholinergic (atropine), -blockers, histamine antagonists and anti-allergic drugs, can not prevent the above neurogenic inflammatory response, these characteristics and exogenous SP caused The local response was the same, but when a large dose of capsaicin (capsaicin) was used to treat the animal before stimulation of the sensory nerve, no such reaction occurred, and capsaicin selectively destroyed the C-type unmyelinated fiber.
Prevention
Over-reflective rhinitis prevention
1. Improve systemic nutrition and eat more fruits.
2. Improve the living and working environment. Operators who are exposed to dust and chemical gases should wear masks and take various safety measures.
3, avoid tobacco, alcohol and spicy food.
4, often wear a mask, wear dry masks in winter, wet in summer.
Complication
Hyperreflexive rhinitis complications Complications rhinitis
There are no obvious complications in this disease.
Symptom
Hyperreflexive rhinitis symptoms Common symptoms Nose red bloodshot nasal congestion Nasal bleeding in the nasal cavity Reflexes weakened unilateral nasal obstruction
Because the symptoms are very similar to other highly reactive nasal diseases, the exact diagnosis is more difficult. The following conditions may be considered:
1 Symptoms come and go quickly, mainly sneezing, with mild nasal congestion;
2 nasal congestion is intermittent and short duration;
3 few noses;
4 Allergen skin test and nasal secretion cytology are negative;
5 antihistamines, anticholinergic efficacy is not obvious;
6 The whole course of disease is often staged, and the interval is longer than the onset period.
Recently, there have been reports of nasal lavage or serum SP determination, and patients with highly reactive nasal disease are higher than normal (1992).
Sensory neuron afferent neurons belong to class C unmyelinated fibers. When retrograde stimulation of sensory nerves, SP is released at the end of class C fibers. SP is a neuropeptide of 11 amino acids that can cause local vasodilation. Increased vascular permeability and tissue edema. It was found that SP can also release histamine from mast cells. Animal experiments also found that retrograde stimulation of the trigeminal nerve intranasal sensory branch of experimental animals can lead to congestion of nasal mucosa and increased vascular permeability. And mucosal edema, if given before the animal anticholinergic (atropine), -blockers, histamine antagonists and anti-allergic drugs, can not prevent the above neurogenic inflammatory response, these characteristics and exogenous SP caused The local response was the same, but when a large dose of capsaicin (capsaicin) was used to treat the animal before stimulation of the sensory nerve, no such reaction occurred, and capsaicin selectively destroyed the C-type unmyelinated fiber.
It can be seen from the above that the neuromuscular inflammation of the nasal mucosa caused by retrograde stimulation of the sensory nerve is a local axonal reflex. SP is a neurotransmitter of this kind of activity, physical, chemical and inflammation, which can cause axonal reflex, under normal circumstances. The nasal epithelium is intact and can be protected from excessive local irritation. The neuropeptide degrading enzyme-neutral endopeptidase present in the nasal mucosa can continuously decompose excess SP, and the local axonal reflex threshold can be achieved through these two mechanisms. Maintained at normal levels, but when mucosal epithelial damage or NEPase activity is reduced by exogenous or endogenous stimuli, the local axonal reflex threshold is reduced, resulting in hyperreactive nasal mucosa.
It is very similar to other highly reactive nasal diseases, but the symptoms are rapid and short-lived. The sneezing is mainly sneezing, there is mild intermittent nasal congestion, the nasal overflow is not obvious, the symptoms can be as usual after the attack, and the patients complain more about the cold. After the onset, the symptoms can disappear after a period of time, no change in nasal examination, nasal smear examination often no characteristic findings.
Examine
Excessive reflex rhinitis examination
No changes in nasal examination, nasal smear examination often no characteristic findings.
Diagnosis
Diagnosis and identification of hyperreflexive rhinitis
diagnosis
Because the symptoms are very similar to other highly reactive nasal diseases, the exact diagnosis is more difficult. The following conditions may be considered:
1 Symptoms come and go quickly, mainly sneezing, with mild nasal congestion;
2 nasal congestion is intermittent and short duration;
3 few noses;
4 Allergen skin test and nasal secretion cytology are negative;
5 antihistamines, anticholinergic efficacy is not obvious;
6 The whole course of disease is often staged, and the interval is longer than the onset period.
Differential diagnosis
Different from other highly reactive nasal diseases.
