Rhinitis ( runny nose ) symptoms
Runny nose (rhinitis) - a general term for a group of weak and highly contagious viral disease that causes inflammation of the mucous membranes of the nose and throat.Symptoms usually appear within two to three days after the collision with the virus;rhinitis is contagious during the first two or three days after the onset of symptoms.For the common cold no treatments;a full recovery takes a week to 10 days.Runny nose is more common in winter than summer and is more common in children than in adults, since the resistance to many viruses develops with age.Runny nose can cause serious complications in patients with chronic respiratory diseases.What advises folk medicine in this illness, see here.
diagnosis can be made on the observed symptoms without the participation of a physician.
Acute rhinitis - non-specific inflammation of the mucous membrane of the nasal cavity, in which there are characteristic symptoms: nasal congestion, rhinorrhea, sneezing, and itchy nose.The diagnosis is the presence of on
The clinic distinguished:
Etiology and pathogenesis .Activators of acute infectious rhinitis can be viruses, bacteria, and their associations.Primary nasal mucosa affect mainly rhinoviruses, adenoviruses, influenza viruses, parainfluenza, and others.
Every virus has a tropism to the epithelium of the nasal mucosa, can cause respiratory infections and acute rhinitis.The virus creates the conditions for activation of the microbial flora, and then the pathogens of acute infectious rhinitis can be a variety of micro-organisms -. Pneumococci, Haemophilus influenzae, streptococci, staphylococci, Moraxella and other
The disease coryza matters and violation of local and general immune defense.This usually happens when the general or local body hypothermia and rapidly develops in people with reduced resistance (especially in the presence of chronic diseases) or attenuated acute diseases.Furthermore, predisposing factors for the development of acute rhinitis can be various mucosal injury, foreign bodies and the state after surgery in the nasal cavity.In some cases the cause of acute rhinitis and can be a productive factor - mechanical and chemical stimuli stone-wood, chemical and other industries (exposure to smoke, gas, dust, etc.).
Morphological changes of the nasal mucosa characterized by the development of typical stages of inflammation: redness replaced serous effusion, edema.Slow down, and eventually stops the movement of the cilia of ciliated epithelium, which promotes the adhesion of pathogens to the mucosa of the nasal cavity.The epithelium and submucous layer gradually become inflamed, develop epithelial desquamation, and mucosal erosions.
Clinic. In a typical hospital acute rhinitis are three stages of flow:
for the disease is characterized by acute onset and defeat once both halves of the nose.Main symptoms: general state of disorder, runny nose and difficulty in nasal breathing.These symptoms may be expressed in varying degrees depending on the stage of the disease.
first stage (dry stage of irritation) usually lasts a few hours, rarely lasts for 1-2 days.Patients concerned about dryness in the nose and nasopharynx, tickling sensation, scratching, burning.At the same time there are malaise, chilliness, heaviness and pain in the head.Often there is an increase in body temperature to 37 ° C and above.In front rhinoscopy noted hyperemia and vascular injection mucosal dryness, lack of discharge.
This period is characterized by intense aggression virus, its replication in the epithelial cells of the nasal mucosa.Virus actively oppose local protection unspecific factors: high role mucociliary epithelial mucus present in secretory immunoglobulins, immune cells and other immune defense factors.
second stage (stage serous exudates) is characterized by the increase of inflammation, there is a large amount of clear watery fluid from the vessels propotevayuschey (transudate).Simultaneously, the function of goblet cells and mucous glands in the nose so the discharge becomes serous-mucous.In transudate contains sodium chloride (table salt) and ammonia, which makes it an irritating effect on the skin of the vestibule of the nose, especially in children.
Burning and dryness in the stage of the disease is reduced, but the violation of breathing through the nose increases, and, as a result of the transition process on track and slezoprovodyaschie auditory tube, often develop conjunctivitis, watery eyes, a feeling of fullness and tinnitus.
Pathomorphology From the viewpoint of the second stage, the involvement in the inflammatory process microvasculature endothelial nasal mucosa.Increased permeability, begins active involvement in the inflammation of immune cells from the vascular bed.
third stage (stage of muco-purulent discharge) comes in 4 - 5 days of onset.The leading role in this time become viral and microbial associations.For viruses damaging epithelial cells joined microbial flora colonizing the nasal mucosa.
Clinically the disease at this stage is characterized by the appearance of a thick scant mucopurulent discharge yellowish-greenish, due to the presence in it of blood cells (inflammatory cells) - propotevayuschih leukocytes, lymphocytes, epithelial ottorgshegosya.Swollen turbinates in this period moderate, mucosa hyperemic with cyanotic shade.
In the following days, the amount of discharge is reduced, the swelling of the mucous membrane disappears, restores nasal breathing, improves the general condition.
After 8 - 12 days from the onset of the disease is stopped coryza.
duration of acute rhinitis depends on the immunobiological state of the body and mucous membranes of the nasal cavity state.With good reactivity and rhinitis with adequate treatment can proceed abortive for 2 - 3 days;the weakening of the protective forces - could be delayed up to 3 - 4 weeks, which suggests the possibility of its transition to the chronic form.
Treatment of acute infectious rhinitis outpatient and is carried out in accordance with the process.
In the initial stage of a cold recommend diaphoretic and distraction procedures.Assign a hot footbath, hand bath or general duration of 10 - 15 minutes, which can be combined with mustard plasters on the calves or on the soles of the feet;immediately after this procedure the patient drinks hot tea with raspberries.In addition, it is advisable to use UHF and MSS on the nose.
In the third stage acute rhinitis can recommend medications binder and antimicrobial nature - 3 to 5% solution of colloid silver or protargola, 20% Albucidum solution, IRS-19 spray;continue physiotherapy, prescribed multivitamins amiksin inside normal human immunoglobulin (3 ml into the muscle once).
In the treatment of rhinitis / rinosinusigov in the presence of a thick discharge effective is the use of mucolytic and mucoregulatory drugs.Good results were observed during treatment with the drug Flyuditek (karbotsistein).The drug effectively dilutes the secret and at the same time stimulates the activity of the ciliated epithelium of the villi, restores the elasticity and viscosity of mucus contributes to the regeneration of the mucous membrane, the restoration of its structure, improves mucociliary clearance, activating activity of ciliated epithelium, restores the synthesis of secretory immunoglobulin A.
Note that infusionany nose drops, injection powder, inhalation and other therapeutic measures should be limited to 8-10 days.Prolonged use of drugs leads to the development of pathological processes. Dysfunction ciliated epithelium, vasomotor function of the nasal mucosa, etc. The patient should be warned that otsmarkivat content from the nose should be gently, without much effort, and only turn through each half of the nose and mouth at the same time mustbe open.
Classification of chronic rhinitis is as follows.
Etiology and pathogenesis. Causes of chronic rhinitis varied.Often the disease develops as a recurrent acute rhinitis, especially if the process involved sinuses.Another reason is the constant exposure to environmental factors: hypothermia, dust, gases and a variety of allergens.An important role is also played by the presence of local changes in the nasal cavity and throat:. Deformation of the nasal septum and other intranasal structures disease paranasal sinuses, adenoids, chronic tonsillitis, etc. Congestion changes in the nasal cavity, leading to chronic rhinitis, can be the result of various somatic diseasesor functional changes in the endocrine and autonomic nervous systems.
Different forms of chronic rhinitis is characterized by clinical manifestations are quite different, and applied to them therapeutic approaches.
Chronic catarrhal rhinitis is characterized by persistent violation of nasal breathing and periodic appearance of mucous secretions from the nose or muco-purulent character.Violation of nasal breathing is enhanced in the cold.In the "lying on its side" stuffy nose is more pronounced in that half of the nose, which is below that explains the blood filling the cavernous cavities of the lower shell.Sometimes there is a violation of the sense of smell (hyposphresia) and / or the transition of the inflammatory process in the mucous membrane of the Eustachian tube (tubo-otitis).
In front rhinoscopy determine congestive hyperemia and swelling of the nasal mucosa (mainly in the lower and middle turbinates), pasty, often with cyanotic tinge, scant mucous discharge.
Treatment of chronic catarrhal rhinitis include elimination of exogenous (production, climate) and endogenous (curvature of the nasal septum, adenoid vegetations) factors.
For local therapy used:
Chronic hypertrophic rhinitis is characterized by the presence of hypertrophic mucosa areas that develop on the surface of most lower and middle turbinates.The surface of these areas may be smooth, uneven or coarse, have a wide base and reach a considerable size.The disease is characterized by a prolonged course, the presence of persistent violation of nasal breathing, often weakening or lack of the sense of smell.
Rinoskopicheskaya picture with catarrhal and hypertrophic rhinitis in many respects similar.To differentiate between these two forms of chronic rhinitis, performed with anemizatsiey sample.Lubricate mucosa vasoconstrictor (0.1% solution of adrenaline galazolin et al.);This occurs when a significant decrease in the volume of the lower nasal turbinate indicates the absence of a true hypertrophy.If they expressed slightly reducing or absent, this indicates a hypertrophic process.
Treatment of hypertrophic rhinitis surgery.The criterion for the choice of treatment in each case is the degree of hypertrophy of the turbinates or other parts of the nasal mucosa, as well as the degree of impairment of nasal breathing.
In patients with moderate hypertrophy, when after anemizatsii (lubrication vasoconstrictor drug) mucosa moderately reduced and improves nasal breathing, apply the most sparing surgery: burning chemicals (30 - 50% solution of silver nitrate, tri-chloroacetic acid and chromic) galvanokaustiku, ultrasonic disintegration of the inferior turbinates, lazerodestruktsiyu, submucosal vasotomy.
In an outpatient setting, you can produce an ultrasonic disintegration of the inferior turbinates (Doppler ultrasound).To do it, use the ultrasound generator with a set of special waveguides.After preliminary applicative and infiltration anesthesia of the inferior turbinate mucosa in its thickness introduced included a waveguide carried them up to the posterior third of the shell and slowly withdrawn back.Of exposure is determined individually.
hypertrophic scarring temperate regions can be achieved by submucosal vasotomy inferior turbinate.After local anesthesia produce a small incision at the anterior end of the inferior turbinate through which rasp otseparovku produce soft tissue from the surface of the bone skeleton shell, forming a narrow channel from the front end to the rear.
similar otseparovku can be made and on the bottom surface of the turbinate.The subsequent scarring of erectile tissue reduces the volume of the shell and thus increases the lumen of the nasal passages, improving breathing.
A more pronounced fibrotic hypertrophy of the mucous membrane and bone bases turbinates, accompanied by a significant impairment of breathing through the nose, usually shows:
These operations are recommended to be combined with a shift turbinate laterally to the side wall of the nose - laterokonhopeksiey.
sparing lower turbinotomy produce in hospital after outpatient examination.In the supine position the patient is carried out local infiltration anesthesia of the mucosa of the lower nasal turbinates.The entire length of the shell in order to reduce bleeding clip applied 1 minute.After removing the clip with special angled scissors cut off the hypertrophied part of the shell.Giperplaziro-Vanny rear end of the shell is easy to remove the bow loops.Turbinotomy should produce more gentle, especially trying to keep the front end of the shell as its complete removal is unacceptable and can lead to atrophy of the mucosa of the nasal cavity.
With the introduction into medical practice of optical systems (endoscopes, microscopes) the effectiveness of intranasal operations increased significantly.Endoscopes enable visual inspection under constant steps intranasal perform all operations, including trudnoobozrimyh posterior nasal cavity.To remove portions of hypertrophied turbinates effective use of various mikrodebriderov (Shaver).These tools are attached to the rotating suck mikrofrezu which can remove the hypertrophied tissue with high accuracy without damaging healthy mucosa.
Depending on its causes chronic atrophic rhinitis is a primary or genuinnym (Ozen), and secondary.Furthermore, dystrophic process can be local (as in the forward dry rhinitis) or diffuse, spreading to the entire nasal cavity.Primary atrophic rhinitis (ozena) is diffuse in nature and may be a manifestation of systemic disease.The cause of secondary atrophic rhinitis is the adverse impact of production and climatic factors - dust, gases, vapors and other
Histology.. Chronic atrophic rhinitis is accompanied by:
As mentioned, chronic atrophic rhinitis is divided into simple and stinking (Ozen).
In simple atrophic rhinitis develop nonspecific changes of the mucous membrane of the nasal cavity, which are based on non-inflammatory and dystrophic process.
Its development often contribute to injuries and extensive surgery in the nasal cavity, such as the radical turbinotomy, removal of the tumor, and others. An important role is also played by endocrine and hormonal disorders and frequent inflammatory disease of the nasal cavity, leading to an increase in trophic changes of the mucous membrane.
Clinic.The clinical picture of simple atrophic rhinitis include complaints of dryness in the nose, crusting, nasal breathing difficulty, decreased sense of smell.