Chronic rhinitis (chronic rhinitis)

Chronic rhinitis (chronic rhinitis) is a nonspecific and specific inflammatory process of the mucous membrane and in some cases of the bony walls of the nasal cavity.

ICD-10 code

• J31.0 Chronic rhinitis.
• J30.0 Vasomotor rhinitis.

Epidemiology of chronic rhinitis

The disease is common. Such epidemiological data are not available

[1], [2],

Causes of chronic rhinitis

As a rule, the emergence of chronic rhinitis is associated with discirculatory and trophic disorders in the mucous membrane of the nasal cavity, which can be caused by such factors as frequent acute inflammatory processes in the nasal cavity (including various infections). Negative influence is also exerted by irritating environmental factors. So, dry, hot, dusty air dries out the mucous membrane of the nasal cavity and depresses the function of the ciliated epithelium. Prolonged exposure to cold leads to changes in the endocrine system (especially in the adrenal glands), which indirectly affect the development of a chronic inflammatory process in the mucosa of the nasal cavity. Irritant toxic effects on the mucous membrane of the nasal cavity are caused by certain industrial gases and toxic volatile substances (for example, mercury, nitric, sulfuric acid vapor), as well as radiative forcing.

[3], [4], [5]

Symptoms of chronic rhinitis

The main symptoms - difficulty in nasal breathing and discharge from the nose (rhinorrhea) - are moderately expressed. The patients usually do not complain about the difficulty of breathing, and only with a thorough questioning can they find out that their breathing is difficult from time to time. It should be noted that sometimes the difficulty of breathing worries the sick, but this symptom is not permanent. Difficulty breathing through the nose occurs more often in the cold, the most constant is the stuffiness of one half. In the supine position on the side, the congestion is more pronounced in that half of the nose, which is lower, which is explained by blood filling of the cavernous vessels of the underlying shells, the venous tone of which is weakened in chronic rhinitis. Detachable from the nose is mucous, usually it is a little, but with the aggravation of the process it becomes purulent and plentiful. The violation of smell (hyposmia) is often temporary, usually associated with an increase in the amount of mucus.

Classification of chronic rhinitis

1. Chronic catarrhal rhinitis.
2. Chronic hypertrophic rhinitis.
   • By the prevalence of the process:
     • diffuse;
     • limited - changes in any part of one of the formations of the nasal cavity (front ends, posterior ends of the nasal concha).
   • According to pathomorphological features:
     • cavernous, or vascular form (usually diffuse):
     • fibrous form - changes are observed more often in the lower or medial nasal concha:
     • bone hypertrophy.
3. Chronic atrophic rhinitis (subatrophic rhinitis).
   • Nonspecific (simple atrophic rhinitis):
     • diffuse;
     • limited.
   • Specific (ozona, or malodorous rhinitis).
4. Vasomotor rhinitis, neurovegetative (reflex) form.

[6]

Diagnosis of chronic rhinitis

In order to make the correct diagnosis, it is necessary to carefully collect the anamnesis - it is important to find out the time and nature of the onset, duration and dynamics of the development of the above symptoms, whether earlier the examination and treatment, including independent, its adequacy and effectiveness.

[7], [8], [9], [10], [11]

Treatment of chronic rhinitis

Indications for hospitalization in chronic rhinitis are the ineffectiveness of conservative treatment, expressed true hypertrophy of the inferior nasal concha, severely hindering nasal breathing, the presence of concomitant pathology requiring surgical treatment.

Treatment is reduced to the elimination of possible endo- and exogenous factors that cause and support the common cold: sanation of purulent-inflammatory diseases of the paranasal sinuses, nasopharynx, palatine tonsils; active therapy of common diseases (obesity, cardiovascular diseases, kidney diseases, etc.); improvement of hygienic conditions in everyday life and at work (elimination or reduction of dustiness and gas contamination of air, etc.).

Patients with chronic rhinitis are shown physiotherapy (thermal procedures on the nose), including exposure to UHF currents or microwaves with endonasal. Conducted also endonasal ultraviolet irradiation through the tube, helium-neon laser; endonasal electrophoresis of 0.5-0.25% zinc sulfate solution, 2% calcium chloride solution, 1% diphenhydramine solution; endonasal phonophoresis of hydrocortisone; magnetotherapy; acupuncture and other effects on biologically active points.