Rhinitis (syn.: Runny nose) - inflammation of the nasal mucosa. Acute rhinitis can be an independent disease (mainly hypothermia serves as a predisposing factor) or a symptom of acute infectious diseases (flu, measles, diphtheria, etc.). Acute rhinitis is always bilateral. Initially, there is a slight malaise, a feeling of dryness in the nasopharynx, itching in the nose. Nasal breathing is difficult, sneezing, lacrimation appear, the sense of smell decreases, the timbre of the voice changes, abundant liquid discharge from the nose is observed. In the future, the discharge becomes mucopurulent, with a violation of the integrity of small blood vessels - bloody. Inflammation of the nasal mucosa can spread to other parts of the respiratory tract, as well as to the paranasal sinuses, nasolacrimal canal, auditory tube, and tympanic cavity. With rhinoscopy, hyperemia and swelling of the nasal mucosa are noted.
At elevated body temperature, bed rest is indicated. Heat to the feet (mustard foot baths), diaphoretic agents, ultraviolet irradiation in erythema doses of the plantar surfaces of the feet have a good effect. Locally, to eliminate swelling of the nasal mucosa, vasoconstrictors are prescribed (0.1% Naftizin solution, 0.1% galazolin solution, etc.), followed by instillation of which vaseline or peach oil is administered. Antibiotic aerosol inhalations may be prescribed. With a favorable course, after 12-14 days, nasal congestion disappears, the sense of smell is restored.
Acute rhinitis in infants always proceeds as acute rhinopharyngitis. Often the process extends to the mucous membrane of the larynx, trachea, bronchi; pneumonia is possible. The baby’s nose is so blocked that it cannot breathe, suckle. Often there are vomiting , diarrhea and flatulence . The child becomes restless, losing weight, sleep is disturbed, body temperature is often elevated.
Prescribe instillation in each half of the nose of a solution of adrenaline 1: 10000 4 drops before feeding, followed by the introduction of a 1% solution of protargol 4 drops 2 times a day. Drugs with menthol and cocaine are not prescribed for children under 3 years of age.
Chronic catarrhal (simple) rhinitis develops with prolonged or recurring acute rhinitis, prolonged exposure to various irritants (chemical, thermal, mechanical), irritation of the nasal mucosa with purulent secretion in diseases of the paranasal sinuses, prolonged circulation disorder in the nasal mucosa (heart defects, myocarditis, nephritis, emphysema, bronchiectasis , endocrine diseases). Periodic nasal congestion and copious discharge from it are noted. Patients indicate that the left half of the nose can be blocked while lying on the left side, the right - on the right, nasal breathing is difficult in the supine position (due to the rush and stagnation of blood in the lower parts of the nose). General condition usually does not suffer. The complete disappearance of swelling of the nasal mucosa after instillation of a 2–3% cocaine solution with epinephrine or a 2–3% ephedrine solution indicates chronic (simple) rhinitis. For therapeutic purposes, nasal drops are prescribed (sanorin, galazolin , etc.). Also, agents with an astringent or cauterizing effect are used: 2 - 3% solution of collargol or protargol, lubrication of the nasal mucosa with 2 - 5% silver nitrate solution. If this treatment is ineffective, the doctor can cauterize the lower nasal concha with trichloroacetic or chromic acid or conduct shallow galvanocaustics.
Chronic hypertrophic rhinitis is a consequence of chronic catarrhal (simple) rhinitis. It usually develops as a result of prolonged exposure to adverse environmental factors. The cause of the disease is often a chronic inflammatory process in the paranasal sinuses or adenoids . It is characterized by proliferation of connective tissue, mainly in the anterior and posterior ends of the lower and middle nasal concha. Constant discharge and nasal congestion, heaviness in the head and headache, and a decrease in smell are noted.
Treatment is carried out by a doctor. With moderate hypertrophy, the lower nasal conchs are cauterized with trichloroacetic or chromic acid. In the absence of effect, they resort to galvanocaustic. Sharply hypertrophic sections of the mucous membrane are removed with a loop or scissors.
Chronic atrophic rhinitis can be caused by adverse climatic conditions, occupational hazards, often recurring acute rhinitis, infectious diseases, etc. There is a feeling of dryness in the nasal cavity, difficulty in blowing out, and a decrease in smell; nosebleeds are frequent. A wide nasal cavity is determined rhinoscopically due to atrophy of mainly the lower nasal concha, an accumulation of thick secretion, which in places, when dried, forms crusts.
The treatment is symptomatic. Thick mucus and crusts are diluted with an alkaline solution. Alkaline oil inhalations (through the nose) are also used.
Vasomotor and allergic rhinitis are characterized by attacks of sudden nasal congestion, profuse watery-mucous secretions, sneezing. Vasomotor rhinitis is observed mainly in individuals with general autonomic disorders. The slightest irritation of the nerve endings of the nasal cavity or distant reflexogenic zones (cooling, pungent smell, etc.) leads to a violent reaction of the nasal mucosa. Allergic rhinitis is considered as a local anaphylactic reaction to any allergen. With the seasonal form of the common cold, cereal pollen (hay cold) can be such an irritant. With a year-round form, the so-called household allergens (cosmetics, house dust, hair and dandruff of domestic animals, etc.) act as irritants. These forms of rhinitis are called rhinopathies, since they usually do not have inflammatory changes. The diagnosis is made on the basis of anamnesis, rhinoscopy and laboratory data. With rhinoscopy, a sharp swelling of the mucous membrane of the nasal concha is determined, which, in contrast to the banal inflammatory processes, has a pale bluish color. With allergies, many eosinophils are found in mucus, edematous polyps are common. Skin tests with an allergen for allergic rhinitis are often positive.
With vasomotor rhinitis, the main attention is paid to hardening the body. Locally apply intranasal novocaine blockade, if necessary - galvanic caustic of the lower shells. In allergic rhinitis, specific hyposensitization is performed. If no allergen is found, then calcium preparations, antihistamines (diphenhydramine, pipolfen, diprazine , suprastin , pernovin, etc.) are prescribed. Topically, hydrocortisone is injected into the lower nasal concha. Successfully use cryotherapy and ultrasound on the lower nasal concha.