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Chronic rhinitis (chronic runny nose) - Treatment
Last reviewed: 04.07.2025
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Goals of treatment for chronic rhinitis
Complete control over the symptoms of chronic rhinitis, improving the patient's quality of life.
Indications for hospitalization
Indications for hospitalization for chronic rhinitis include the ineffectiveness of conservative treatment, severe true hypertrophy of the inferior nasal turbinates, which greatly impedes nasal breathing, and 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 maintain rhinitis: sanitation of purulent-inflammatory diseases of the paranasal sinuses, nasopharynx, palatine tonsils; active therapy of general diseases (obesity, cardiovascular diseases, kidney diseases, etc.); improvement of hygienic conditions at home and at work (elimination or reduction of dust and air pollution, etc.).
Patients with chronic rhinitis are prescribed physiotherapy (thermal procedures on the nose), including exposure to UHF currents or microwaves endonasally. Endonasal ultraviolet irradiation through a tube, a helium-neon laser; endonasal electrophoresis of 0.5-0.25% zinc sulfate solution, 2% calcium chloride solution, 1% diphenhydramine solution; endonasal phonophoresis of hydrocortisone; magnetic therapy; acupuncture and other effects on biologically active points.
Spa treatment (Anapa, Borovoe, Vladivostok resort area, Gelemdzhik group of resorts, Kuryi, Leningrad resort area, Yumatovo), balneotherapy (Golovinka, Kislovodsk, Lazarevskoye, Nalchik, Shusha, Shivanda) and mud therapy (Nalchik, Pyatigorsk, Sadgorod) are indicated.
Drug treatment of chronic rhinitis
Chronic catarrhal rhinitis
Antibacterial drops and ointments are prescribed (polydex with fedilephrine, 2% sulfanilamide and 2% salicylic ointments, mupirocin), astringents (3-5% collargol, silver proteinate).
Chronic hypertrophic rhinitis
In case of slight hypertrophy, sclerosing therapy is prescribed - the introduction of a hydrocortisone suspension into the anterior end of the inferior turbinate (1 ml on each side once every 4 days, a total of 8-10 procedures) and splenin, starting with 0.5 ml to 1 ml every other day. Cauterization with chemicals (silver nitrate, trichloroacetic and chromic acid) is also indicated.
Chronic atrophic rhinitis
Treatment is mainly symptomatic - irrigation of the nasal cavity with a 0.9% sodium chloride solution with the addition of iodine, sea water preparations; nasal douche using the Dolphin device and a sea salt solution; irritant therapy (lubrication of the nasal mucosa with a 0.5% iodine-glycerol solution, etc.).
Vasomotor rhinitis
Prescribed are systemic antihistamines (loratadine, fexofenadine, desloratadine, ebastine, cetirizine, etc.); local antiallergic drugs (mometasone, dimethindene) in the form of drops, spray or gel; endonasal blockades with procaine (anterior ends of the inferior turbinates, nasal ridge). Intramucosal administration of glucocorticoids, point cauterization of reflexogenic zones with chemicals, sclerosing therapy, and nasal infusion of astringent drugs are also indicated for vasomotor rhinitis.
Surgical treatment of chronic rhinitis
Chronic hypertrophic rhinitis
In case of minor hypertrophy, submucous ultrasonic disintegration of the inferior nasal turbinates, laser destruction, vasotomy are performed, and in case of severe hypertrophy, gentle inferior conchotomy, submucous removal of the bone edge of the inferior nasal turbinate (osteoconchotomy) using endoscopes or microscopes, and lateroconchopexy are performed.
Vasomotor rhinitis
Submucous vasotomy of the inferior turbinates, ultrasound or microwave disintegration of the inferior turbinates, and submucous laser destruction of the inferior turbinates are performed. If these methods are ineffective, a gentle inferior conchotomy is indicated.
Further management
Sanitizing rhinoscopy using vasoconstrictor drugs, local application of symptomatic agents, local application of antibacterial agents.
Forecast
Favorable. The approximate period of incapacity is 6-7 days.
Prevention of chronic rhinitis
Treatment of acute and chronic infections, especially in the oral cavity, pharynx, paranasal sinuses. Of great importance is the hardening of the body, which is essentially a therapeutic factor.
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