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Chronic rhinitis (chronic runny nose): treatment
Last reviewed: 19.10.2021
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The goals of treatment of chronic rhinitis
Complete control over the symptoms of chronic rhinitis, improving the quality of life of the patient.
Indications for hospitalization
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.
Non-drug treatment of chronic rhinitis
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.
Balneotherapy (Anapa, Borovoye, Vladivostok resort zone, Gelmdzhik group of resorts, Kuryi, Leningrad resort zone, Yumatovo), balneotherapy (Golovinka, Kislovodsk, Lazarevskoye, Nalchik, Shusha, Shivanda) and mud therapy (Nalchik, Pyatigorsk, Sadgorod) are shown.
Drug treatment for chronic rhinitis
Chronic catarrhal rhinitis
Assign antibacterial drops and ointments (polidex with fedilafrinom, 2% sulfanilamide and 2% salicylic ointment, mupirocin), astringents (3-5% collargol, silver proteinate).
Chronic hypertrophic rhinitis
With a slight hypertrophy, sclerosing therapy is prescribed-the introduction of a suspension of hydrocortisone (1 ml on each side once every 4 days, in total 8-10 procedures) and splenin, starting at 0.5 ml to 1 ml every other day, at the anterior end of the inferior nasal concha. Cauterization with chemicals (silver nitrate, trichloroacetic and chromic acid) is also shown.
Chronic atrophic rhinitis
Treatment is mainly symptomatic - irrigation of the nasal cavity with 0.9% solution of sodium chloride with the addition of iodine, preparations of sea water; Nasal shower with the help of the device "Dolphin" and sea salt solution; irritating therapy (lubrication of the nasal mucosa with a 0.5% iodine-glycerol solution, etc.).
Vasomotor rhinitis
Assign systemic antihistamines (loratadine, fexofenadine, desloratadine, ebastin, cetirizine, etc.); antiallergic agents of local action (mometasone, dimethindene) in the form of drops, spray or gel; endonasal blockades with procaine (the anterior ends of the inferior nasal concha, the nose roller). Intravenous administration of glycocorticoids, point cauterization of reflexogenic zones by chemical substances, sclerosing therapy, infusion of astringents into the nose are also indicated with vasomotor rhinitis.
Surgical treatment of chronic rhinitis
Chronic hypertrophic rhinitis
With slight hypertrophy, submucosal ultrasound disintegration of the inferior nasal concha, lasodestruction, vasotomia is performed, and with severe hypertrophy - sparing lower concomitomy, submucosal removal of the bone edge of the inferior nasal concha (osteochondhotomy) with the use of endoscopes or microscopes, lateroconchopexy.
Vasomotor rhinitis
Perform a submucous vasotomy of the inferior nasal cavity, ultrasonic or microwave disintegration of the inferior nasal concha, submucosal laserodeuculation of the inferior nasal concha. If these methods are ineffective, a sparing lower cochomatomy is shown.
Further management
Sanitary rinoscopy using vasoconstrictive drugs, Local application of symptomatic agents, topical application of antibacterial agents.
Forecast
Favorable. Approximate terms of incapacity for work are 6-7 days.
Prophylaxis of chronic rhinitis
Cure acute and chronic infections, especially in the oral cavity, pharynx, paranasal sinuses. Of great importance is the tempering of the body, which refers in essence to medical factors.
[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15]