rhinitis
Introduction
Introduction to rhinitis Rhinitis, a nasal inflammatory disease, is inflammation of the nasal mucosa caused by viruses, bacteria, allergens, various physical and chemical factors, and certain systemic diseases. The main pathological changes of rhinitis are nasal mucosal congestion, swelling, exudation, hyperplasia, atrophy or necrosis. basic knowledge The proportion of illness: 0.3% (the incidence of chronic rhinitis is 1-3%) Susceptible people: no special people Mode of infection: non-infectious Complications: sinusitis, purulent sinusitis
Cause
Cause of rhinitis
Local cause (30%):
Acute rhinitis recurs or the treatment is not complete and evolves into chronic rhinitis.
Systemic cause (30%):
Long-term chronic diseases, such as endocrine disorders, long-term constipation, kidney disease and cardiovascular disease, cause long-term or repeated congestion or blood stasis of the nasal mucosa.
Environmental factors (20%):
In workers with environments such as cement, tobacco, coal dust, flour or chemicals, the nasal mucosa is irritated and damaged by physical and chemical factors that can cause chronic rhinitis.
Local cause
Due to long-term stimulation or malformation of adjacent chronic inflammation, nasal ventilation or drainage obstruction, such as chronic sinusitis, nasal septum deviation, chronic tonsillitis or adenoid hypertrophy.
Nasal medication is inappropriate or excessively long to form rhinitis medicamentosa, which is common after long-term use of nasal drops.
Systemic cause
Vitamin deficiency, such as vitamin A or C.
Excessive alcohol and tobacco can affect the vasomotor contraction of the nasal mucosa and cause obstacles.
Long-term use of blood-relieving antihypertensive drugs can cause nasal vasodilatation and produce symptoms like rhinitis.
Endocrine diseases or disorders: such as hypothyroidism can cause nasal mucosal edema. In the late pregnancy and adolescence, the nasal mucosa often has physiological congestion and swelling.
envirnmental factor
Environments with drastic changes in temperature and humidity, such as steelmaking, freezing, and melting, are also more likely to occur.
Prevention
Rhinitis prevention
1, quit smoking and alcohol, pay attention to food hygiene and environmental hygiene, to avoid long-term stimulation of dust.
2, the treatment process should be combined with physical therapy to enhance physical fitness and disease resistance.
3, to avoid local long-term use of ephedrine nasal drops, chronic simple rhinitis nasal mucosa smooth, elastic, sensitive to vasoconstrictors; and chronic hypertrophic rhinitis generally due to mucosal hypertrophy, not sensitive to vasoconstrictors, so even if ephedrine There is no significant reduction in posterior nasal congestion, and it can cause olfactory disturbance, headache, memory loss, and may cause "pharmaceutical rhinitis."
4, active treatment of acute rhinitis, every time you have a cold nasal congestion, can not use force to nose, so as not to cause nasal infection. Pay attention to environmental hygiene, and smokers and alcoholics should naturally quit.
5, develop a good health habit of washing your nose in the morning and evening.
6, pay attention to nasal cleansing, often clean the nasal cavity.
Complication
Rhinitis complications Complications Sinusitis Suppurative sinusitis
1, nasal polyps: manifested as nasal obstruction, lower nose hypertrophy, but also can have changes in the nasal polyps.
2, bronchial asthma: less than half of patients with hay fever and some patients with perennial allergic rhinitis have bronchial asthma, which is caused by allergic bronchial disease, and its sensitizer is also consistent with allergic rhinitis. Generally, bronchial asthma occurs only a few years after the appearance of nasal and ocular symptoms. A persistent, long-lasting cough before the onset of asthma is a prodromal symptom of asthma caused by allergic bronchitis. Very few patients have asthma with both nasal and ocular symptoms, and a small number of children have asthma. It is often found that in young children, nasal symptoms appear only a few years later, at which time asthma may still be in episodes, or there may be no clinical manifestations.
3, otitis media: due to swelling or edema of the nasal mucosa and eustachian tube mucosa continuous, eustachian tube mucosa can also occur the same lesions. When the tympanic membrane mucosa is swollen and edema reaches a certain level, it can cause obstruction of the eustachian tube, effusion in the middle ear cavity, and the occurrence of audible deafness, which is allergic otitis media.
4, sinusitis: due to swelling or edema of the nasal mucosa blocked in the middle nasal passages and upper nasal sinus opening. Almost all patients with allergic rhinitis have varying degrees of allergic sinusitis, and the invaded sinus is often bilateral and total sinus.
5, allergic pharyngitis: nasal allergic reaction can spread to the throat, the patient has itchy throat, cough, mild hoarseness, severe cases may occur epiglottis, vocal cord mucosal edema and breathing difficulties. Allergic rhinitis can cause a variety of serious complications, so it is necessary to pay attention to the active treatment of allergic rhinitis to avoid complications.
6, sleep disorders: chronic rhinitis patients often due to the release of inflammatory mediators and inflammatory cells active caused by congestion and obstruction of the nasal cavity, seriously affecting the quality of sleep, resulting in daytime learning ability, work efficiency and quality of life decline.
Symptom
Symptoms of rhinitis Common symptoms Runny nose, frontal sinus cyst, nasal mucosa, dry itchy, deep nasal congestion, nasal bleeding, nasal acid, nasal mucosa, pale edema, nasal discharge, discharge of purulent or...
1, nasal congestion nasal congestion is characterized by intermittent. Nasal congestion is relieved during the day, during hot weather, during work or exercise; at night, during a sit-up or cold, the nasal congestion is aggravated. Another feature of nasal congestion is alternation. If lying on the side, the nasal cavity on the lower side is blocked, and the upper nasal cavity is well ventilated. Due to nasal congestion, olfactory sensation, headache, dizziness, and speech, such as occlusive nasal sounds.
2, often more mucinous or sticky purulent, occasionally purulent. More purulent appearance occurs after a seasonal infection.
3, the decline in olfactory is caused by two reasons: one is swelling of the nasal mucosa, nasal congestion, airflow can not enter the olfactory area; second, the mucosa of the olfactory area is stimulated by chronic inflammation for a long time, and the olfactory function is reduced or disappeared.
4, headache, dizziness, chronic sinusitis, more expressed as a heavy head.
5, systemic performance Most people have headaches, loss of appetite, easy fatigue, memory loss and insomnia.
Examine
Rhinitis examination
1. Anterior endoscopy: This type of examination mainly determines the type of rhinitis by observing the color and shape of the nasal mucosa and the nature and location of the secretion. In the early stage of acute rhinitis, the mucous membrane is red and bloody, with mucous secretions. The chronic rhinitis mucosa is dark red, and the front end of the inferior turbinate is sometimes mulberry-like, and the secretion is mucopurulent. Allergic rhinitis has pale edema, or a pale blue color, and the secretions are dilute. Atrophic rhinitis mucosa is atrophied, dry, covered with purulent sputum, the turbinate is reduced, and the nasal cavity is wide.
2, X-ray nasolacrimal duct angiography: This examination is mainly to determine whether there is a sinus infection in the nasal cavity.
3, nasal secretion examination: allergic rhinitis has eosinophils or mast cells; acute rhinitis has a large number of neutrophils. If an allergic skin test is performed, allergic rhinitis is a positive reaction; acute rhinitis is a negative reaction.
4, nasal endoscopy will check: nasal endoscope has become an effective tool for otolaryngologists to diagnose and treat nasal diseases. During the examination, the doctor extends the nasal endoscope into the nasal cavity of the patient, and then carefully examines the parts that need to be understood. Because the nasal endoscope is well illuminated and has high definition, it can be clearly seen deep, narrow, and cannot be in the amount. The structure directly seen under the mirror.
Diagnosis
Rhinitis diagnosis and identification
According to the characteristics of alternating and intermittent nasal congestion, combined with clinical examination, diagnosis is not difficult.
