Nasal hyperplasia

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How to treat hypertrophy of the nasal mucosa?

Sinus hypertrophy is a rare disease that is characterized as an overgrowth of the nasal mucosa. At this time, patients suffer from severe nasal congestion, headaches and deterioration of smell.

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Other symptoms include a nasal voice and changes in timbre. Patients often notice signs of fatigue, decreased hearing acuity, loss of sleep and appetite. Such processes occur due to inflammation in the area of ​​the periosteum and bone of the nasal concha.

If the inflammation is not treated, patients experience a complete loss of smell. This factor can be predicted if treatment for hypertrophy of the nasal mucosa is started in a timely manner.

What is hyperplasia

Hyperplasia of the nasal mucosa is an inflammation during which the patient’s sense of smell is reduced, nasal breathing is impaired, and abundant mucous or purulent discharge appears, which is difficult to separate from the nasal mucosa.

Hypertrophy of the mucous membrane provokes a narrowing of the lymph nodes, which negatively affects the outflow of lymph from the head cavity.

This provokes the appearance of severe pain in the head, shooting sensations when bending over, a feeling of dryness in the mucous membranes and nasal congestion, which becomes chronic as the disease progresses.

When the turbinates are inflamed, rhinitis is the main symptom of the disease. As the disease progresses, a runny nose can even visually change the shape of the nose.

In addition to the listed symptoms, patients complain of pain in the jaw. It may intensify while eating, and when walking or running quickly, the oral cavity remains open. Such signs require prompt medical intervention, since complications of hypertrophy are especially dangerous.

When the disease is diagnosed, the patient is sent for endoscopic examination. During the examination, the patient is noted to have thickening of the nasal mucosa and its growth in the area of ​​the inferior concha, in the middle cavity, and in some cases in the outer part of the nasal septum.

It is necessary to cure inflammation as quickly as possible, since hyperplasia causes the shell to grow, which provokes the accumulation of a large amount of mucus and pus in this part.

As inflammation progresses, these secretions can cause more severe illnesses, including Eustachian tube disease and severe compression in the area of ​​the auditory tube. Such symptoms often cause eustachitis.

Thickening of the mucosa always causes a number of negative symptoms. Most often, patients at this time complain of profuse lacrimation and conjunctivitis, and strong pressure causes pain in the head.

Diagnosis and treatment

It is possible to determine the nature and degree of inflammation by diagnosing the disease through endoscopic examination. It will allow you to determine not only the localization of inflammation, but also the degree of proliferation of the mucous membrane.

Subsequently, the otolaryngologist examines the nasal cavity itself, the condition of the mucous membrane and conducts other necessary studies using X-rays and computed tomography.

After drawing up an accurate picture, the doctor prescribes medication.

With hypertrophy of the nasal sinuses, the patient suffers from a severe runny nose, so first of all it is necessary to eliminate its symptoms and reduce the amount of mucus.

To do this, it is necessary to identify provoking factors and completely eliminate them.

In some cases, rhinitis can cause inflammation in the paranasal sinuses, sinusitis or sinusitis, exposure to dust, chemical objects or allergens.

Drug treatment

To eliminate symptoms you must:

  1. Rinse your nose with specialized solutions “Marimer”, “Otrivin More”, “Salin”, “Morenazal” or saline solutions made from furatsilin or decoctions of medicinal plants. To treat small children, it is necessary to purchase a nozzle ejector.
  2. Use vasoconstrictor drugs “Galazolin”, “Dlyanos”, “Otrivin”, “Xymelin”. When using them, it is necessary to strictly follow the dosage and not violate the course of treatment.
  3. Decongestant drugs “Mannitol”, “Venen”, “Indomethacin”, “Hexapneumin”, “Diclobene” are needed.

But be prepared for the fact that drug therapy is only one of the points of treatment. It is impossible to get rid of hyperplasia of the nasal mucosa with medications alone, so the next stage of treatment will be surgery.

Surgical intervention

In the case of a mild course of the disease and a not very enlarged mucous membrane, the patient will undergo a gentle operation, during which the patient will undergo cauterization with chromic acid and direct injection of cautery into the cavity of the nasal passages. Using a medical instrument, the lower edge of the nasal concha is cauterized.

This method is considered particularly painful, so over time it is increasingly being replaced by ultrasound surgery or applying cold to the affected part.

In each case, surgery is performed under general anesthesia.

The subsequent rehabilitation course takes up to seven days. During the healing process, the patient is prescribed anesthetics and physical therapy.

Physiotherapeutic exercises

During rehabilitation, the patient needs physiotherapeutic exercises.

In case of mucosal hyperplasia, patients are prescribed UHF therapy.

Subsequently, massage, nasal rinsing and ultraviolet radiation are prescribed.

It is very important to treat nasal hyperplasia in the early stages. Subsequently, if treatment is not timely, the patient can expect dangerous and even uncontrollable consequences. Untreated inflammation often causes the formation of eustachitis, tubo-otitis, sinusitis, tonsillitis and tracheobronchitis.

Preventive measures

For prevention purposes, it is necessary to promptly treat all colds and infectious infections of the body. Make sure that rhinitis does not develop into a chronic stage.

In addition, it is important to strengthen the body’s immune system in a timely manner, monitor nutrition and exercise.

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All information on the site is for informational purposes only and does not claim to be absolutely accurate from a medical point of view. Treatment must be carried out by a qualified doctor. By self-medicating you can harm yourself!

Source: http://gorlonos.com/drugie-zabolevaniya/kak-lechit-gipertrofiyu-slizistoj-nosa.html

Hypertrophic rhinitis

Hypertrophic rhinitis is an inflammatory disease of the nasal cavity, which is characterized by the proliferation of the mucous membrane lining it. In advanced cases, inflammation involves bone elements and periosteum. The main symptoms are nasal congestion, difficulty breathing, nasal tone, and occasional headache. Diagnosis of rhinitis includes examination by an otolaryngologist with rhinoscopy and endoscopy. To clarify the diagnosis, X-rays and CT scans of the paranasal sinuses are performed. Treatment at the initial stage is conservative, with the prescription of anti-inflammatory, vasoconstrictor drops. In case of diffuse damage, surgery is performed to remove pathological growths of the mucous layer or bone tissue.

Hypertrophic rhinitis

Hypertrophic (hyperplastic) rhinitis is a chronic diffuse or limited lesion of the nasal cavity. The incidence of the disease is 6-16% among all pathologies of the ENT organs. The term “hyperplastic rhinitis” was first introduced in the 80s of the twentieth century by the Soviet otolaryngologist L.B. Daynyak, who developed a classification of chronic rhinitis. The exacerbation occurs in the spring and autumn, during the period of increasing the number of patients with ARVI. The disease most often affects people aged 25 to 55 years, who have weakened immunity and work in hazardous industries.

Causes of hypertrophic rhinitis

Hyperplastic rhinitis is a polyetiological disease that can progress over several years. The main reasons that provoke the development of rhinitis include:

  • Often recurrent and advanced forms of rhinitis with exacerbations more than 3-5 times a year.
  • Deviation of the nasal septum, leading to narrowing of the nasal passages and difficulty in the normal outflow of secretions.
  • Congenital or acquired anomalies in the development of the nasal passages, injuries to the facial skeleton, causing impaired outflow and stagnation of mucous secretion.
  • Uncontrolled intake of vasoconstrictor drops, leading to disruption of the trophism of the tissues of the nasal cavity. The mucous membrane of the nasal cavity compensatory increases in size, the vessels become fragile, and frequent nosebleeds occur.
  • External factors (environmental conditions, work in hazardous industries, prolonged stay in areas with low or high temperatures, inhalation of dust and gases). These effects damage the inner lining and worsen metabolic processes in the nasal cavity.
  • Diseases of the cardiovascular system. Hypertension and vascular atherosclerosis lead to impaired blood supply to the nasal mucosa and the occurrence of tissue hypoxia.
  • Other diseases of the nasopharynx. Cysts, nasal polyps, and adenoids are the cause of chronic, often recurrent infectious processes, leading to persistent swelling and hypertrophy of the inner lining of the nasal passages.

Pathogenesis

Exposure to exogenous and endogenous factors over a long period of time leads to irreversible changes in the morphological structures of the nasal cavity. Frequent inhalation of dust causes damage to the ciliated epithelium, promoting the development of metaplasia and slowing the outflow of secretions, the formation of rhinoliths (nasal stones). Chemical vapors injure the mucous membrane, causing acute and chronic inflammatory processes. Often recurrent infectious diseases in the acute phase cause the formation of immune complexes and the activation of specific antibodies. As a result, the work of the secretory apparatus and the amount of mucus produced increases, and the inner membrane thickens. Thus, prolonged inflammation, persistent tissue hypoxia, impaired capillary circulation, a decrease in the body’s defenses and exposure to pathogenic flora play a role in the development of hypertrophic changes in the nasal passages.

Classification

Among specialists in the field of otolaryngology, the most popular classification of hypertrophy is based on the extent of damage to the nasal cavity. There are 2 forms of hypertrophic rhinitis:

  1. Diffuse rhinitis is characterized by widespread damage to the mucous layer, periosteum and bone tissue of the nasal passages. The thickness of the inner lining of the nasal cavity is uniformly increased throughout.
  2. Limited rhinitis. A local lesion covers a certain area of ​​the nasal turbinates, causing polypous hyperplasia; the rest of the tissue functions normally. This group has different localization and more often causes hypertrophy of the lower and middle parts of the nasal cavity.

Symptoms of hypertrophic rhinitis

The main manifestations of hyperplastic rhinitis include difficulty in nasal breathing and constant nasal congestion. Patients complain of mucous and purulent discharge from the nose, mainly in the morning. Over time, vasoconstrictor and anti-inflammatory therapy loses its effectiveness. Breathing is primarily through the mouth, which causes dry mouth, snoring, and episodes of sleep apnea. Subsequently, a sensation of a foreign body in the nasopharynx, increased fatigue, aching headache, and insomnia occur. The ability to perceive odors decreases, leading to loss of smell (anosmia). Patients experience a change in voice timbre (closed nasality). Self-cleansing of the nasal passages from pathological secretions causes damage to the mucous membrane, as a result, increased bleeding.

Complications

Untimely diagnosis and treatment of hypertrophic rhinitis leads to complications in the organs of hearing, smell and respiratory system. Enlargement of the posterior sections of the inferior turbinates can lead to obstruction of the lumen of the auditory canal, active proliferation of opportunistic microflora and the development of eustachitis and otitis media. Excessive accumulation of ear secretions contributes to the appearance of congestion, swelling and inflammation of the mucous membrane.

The spread of the inflammatory process to the paranasal sinuses causes sinusitis (sinusitis, sinusitis). Hypertrophy of the inferior turbinate leads to inflammation of the lacrimal ducts, the development of dacryocystitis, and conjunctivitis. Due to constant mouth breathing, patients with hyperplasia of the mucous membrane of the nasal passages are prone to the development of pharyngitis, tracheitis and bronchitis. A long-term inflammatory process leads to the formation of outgrowths of the mucous layer of the nasal cavity - polyps of various sizes and locations.

Diagnostics

To make a diagnosis, determine the form and stage of hypertrophic lesions, as well as exclude other inflammatory diseases of the nasal cavity, a comprehensive assessment of the condition of the anatomical structures of the nose is carried out. The main diagnostic procedures include:

  1. Examination by an otolaryngologist with rhinoscopy. During the examination, a curvature of the nasal septum, mucous or mucopurulent discharge, and dense polyp-like growths of the mucous membrane of various sizes are detected.
  2. Endoscopy of the nasal cavity allows you to determine the localization of hypertrophy, the condition of the mucous layer, septum and turbinates (size, color, shape, vasculature). In the presence of polypous formations, tissue is collected for histological examination (biopsy).
  3. Rhinopneumometry determines the volume of air passing through the nasal passages over a certain time. With mucosal hyperplasia, this ability is reduced, and nasal breathing becomes forced.
  4. X-ray and CT scans of the paranasal sinuses are additional research methods and are performed to exclude inflammatory diseases (sinusitis, sinusitis, sinusitis).

Differential diagnosis of hypertrophic rhinitis should be carried out with the proliferation of the nasopharyngeal tonsil, choanal atresia, polyposis inflammation of the sinuses, specific infectious diseases (tuberculosis, syphilis), neoplasms of the nasal cavity, foreign bodies. An important role in making a diagnosis is played by the differential diagnosis of hypertrophic and other types of rhinitis (vasomotor, catarrhal).

Treatment of hypertrophic rhinitis

Conservative therapy is effective only in the initial stages of the disease. During this period, vasoconstrictor and anti-inflammatory drops are used, ultraviolet irradiation of the nasal cavity, exposure to high-frequency radiation, and nasal massage using 20% ​​splenin ointment are prescribed. In case of diffuse proliferation of tissues of the mucous layer of the nasal cavity and the ineffectiveness of conservative therapy, the only treatment method is surgery. Surgical intervention is a mechanical, laser, thermal effect on the affected part of the nasal concha in order to restore nasal breathing, sense of smell and prevent further pathological growth of the mucous membrane. The following types of operations are performed:

  • Conchotomy (submucosal, total, partial) – excision of a section of the mucous layer of the lower and middle parts of the nasal concha. If the periosteum and bone tissue are involved in the pathological process, partial or complete removal of the inner lining of the nasal cavity along with bone elements is performed (osteoconchotomy).
  • Cryodestruction is the effect on hypertrophied areas with a special applicator cooled with liquid nitrogen.
  • Laser vasotomy – coagulation of vessels located under the mucous layer of the nasal cavity. Used for mild illness.
  • Ultrasonic disintegration of the nasal passages - sclerosis of the blood vessels of the nasal cavity under the influence of ultrasound.

Prevention

To prevent the development of hypertrophic rhinitis, it is necessary to stop smoking and excessive alcohol consumption. An important aspect of prevention is timely treatment of exacerbations of rhinitis, sinusitis, and sinusitis. To strengthen the immune system, regular exercise, proper nutrition, and walks in the fresh air are recommended. It is necessary to eliminate provoking factors - exposure to allergens, dust, gases, low and high temperatures. In order to prevent growths, sanatorium-resort treatment is indicated once a year.

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Chapter IV

Turbinate hyperplasia

Anatomical and physiological essay

Surgical interventions are most often performed on the lower and middle conchas; The upper concha, if sometimes it is necessary to operate, is only simultaneously with interventions on the posterior ethmoid cells or the main sinus.

The lower shell is a slightly curved triangular plate, with its obtuse (sometimes right) angle facing upward and its base downward. With two edges, of which the posterior one is twice as long as the anterior one, this plate is fused with the lateral wall of the nose, so that only its lower, slightly arched and thickened edge, often slightly turned outward, remains free. Between the concha and the side wall of the nose there remains a space - the lower nasal meatus, 1.5 centimeters from the front end of which there is its apex or dome, where the nasolacrimal canal opens and where the lower concha gives off a process involved in the formation of this canal. The shape of the concha, its convexity, the distance of the lower edge from the bottom of the nose, the distance of the concha from the nasal septum and from the lateral wall of the nose, as well as the width and height of the lower nasal meatus are subject to large fluctuations.

The middle concha also has the shape of a triangular plate, but it has only one - the upper - edge fused with the lateral wall of the nose, and both lower edges remain free. Therefore, the middle concha, unlike the lower one, can be easily bent to the side in order to examine the middle nasal passage located here, where the paranasal sinuses open in the semilunar fissure (only the uppermost part of this fissure remains covered by the fixed part of the concha).

Rice. 30. Incision through the mucous membrane of the inferior concha (micrograph).

1 - ciliated epithelium; 2 - glandular layer; 3, 4 - cavernous tissue; 5, 7, 8 - glands; 6 - artery; 9 - vein.

The middle and lower conchae are covered with a rather thick mucous membrane, which, in addition to the epithelial cover, serous and mucous glands and lymphadenoid tissue, contains abundant cavernous tissue, i.e. a dense network of broad venous plexuses richly supplied with smooth muscles (Fig. 30). Under the influence of various physicochemical, physiological and pathological factors (temperature, atmospheric pressure, humidity, dust, toxins, chemical agents, reflexes from distant organs, emotions, etc.), the cavernous tissue of shells is capable of rapidly contracting and expanding, narrowing or expanding at the same time the nasal cavity.

The physiological significance of cavernous tissue for breathing lies mainly in the fact that, like a rheostat, it automatically regulates the strength of the air flow and its direction depending on the properties of the air and the quantity required at the moment. Naturally, dusty, dry and cold air especially needs preparation from the nasal cavity - heating, cleansing and moisturizing.

Therefore, it is physiologically important that in this case the inhaled air passes through the nasal cavity in a narrow and winding stream, in the closest contact with the nasal mucosa. On the contrary, moist, clean and warm air needs less processing, so it can be released in a wider stream.

When running, it is important that the air inhaled in large quantities meets minimal resistance in the nasal cavity. At rest, on the contrary, it is more beneficial to breathe through a narrowed nasal cavity, since the resistance to exhalation encountered in this case, increasing intrathoracic pressure, increases the degree of oxygen absorption by the lungs.

V.F. Undritz and R.A. Hickeys, through an experiment on animals, showed that after removal of the turbinates, the nasal cavity is deprived of the possibility of functional adaptation, i.e., narrowing and expansion due to vasomotor reflexes.

From all that has been said, it follows that the tissues of the nasal turbinates must be treated very carefully - they should be removed and burned only if there are sufficient indications for this.

An increase in the size of the shells (usually simultaneously with swelling of the mucous membrane of the entire nasal cavity) may be a consequence of overflow of the cavernous tissue and the phenomena of productive and exudative chronic inflammation or hyperplasia of all tissues of the shell, starting with the epithelium, glands, connective and lymphadenoid tissue, etc. and ending bony base of shells. In this case, epithelial hyperplasia is usually accompanied by metaplasia, i.e., the transformation of ciliated epithelium into cubic, flat, and sometimes even keratinized.

Source: http://www.medvvman.ru/nos/04_01.htm

Hypertrophy of the nasal mucosa: causes and treatment

Full nasal breathing is the key to optimal functioning of the systems of the whole body. When it is disrupted, the brain stops receiving a sufficient amount of necessary oxygen. The air in the nose is also warmed, moistened and purified.

With diseases of the respiratory system, a person’s well-being worsens. When the nose is stuffy, the patient breathes through the mouth. Performance decreases, memory weakens, irritability, headache, and dizziness appear. Night sleep is disturbed.

Etiology

Turbinate hypertrophy is the most common pathology of the nose. The provoking factor is chronic hypertrophic rhinitis.

The nasal epithelium is penetrated by many blood vessels. They form cavernous (cavernous) plexuses. Capillaries have a thin wall with muscle fibers that contribute to the expansion and contraction of blood vessels. When their vasomotor (constriction-expansion) activity is disrupted, swelling of the mucous membrane occurs. There is an overgrowth of the nasal mucosa. The nasal passages narrow, air flow decreases and shortness of breath develops.

Often hypertrophy is combined with deformation of the nasal septum. This leads to disruption of proper breathing. Sometimes the pathology manifests itself in adolescence due to changes in hormonal levels in the body.

There are two forms of the disease: diffuse (spread) and limited. Usually the tissue of the lower part of the shells is affected. Changes in the cavernous tissue (the middle part of the nasal cavity) are less common.

Symptoms

Thickening of the mucosa is accompanied by:

  • Difficulty in nasal breathing. It improves somewhat after using vasoconstrictors, but for a short time.
  • Mucous and purulent mucous discharge.
  • Discomfort in the nasopharynx (dry nose, dry mouth).
  • Periodic headache.

Accumulated mucus causes a sensation of a lump or foreign body in the throat. Removing secretions by blowing your nose is difficult. Sometimes the acuity of smell and taste decreases.

Secondary symptoms (consequences) of hypertrophy of the nasal mucosa:

  • nasality (talking “in the nose”);
  • hearing impairment (tubo-otitis) – develops as a consequence of poor ventilation of the auditory tube;
  • conjunctivitis, dacryocystitis (inflammation of the lacrimal sac) – noted when changes occur in the anterior lower part of the concha, when the opening of the nasolacrimal canal is compressed.

In some cases, the formation of polyps is observed during the growth of the cavernous bodies. This pathology often has to be treated promptly.

Diagnostics

The main and most effective research method is endoscopy. It allows you to accurately determine the extent and location of the pathology.

During rhinodiagnosis, hyperplasia (thickening) of the nasal membrane of the lower part, and less often of the middle part, is noted. The surface of the changed areas varies from smooth to bumpy. The mucous membrane is reddened and somewhat bluish. There is no enlargement of the nasal turbinates due to thickening of the bone base.

Another examination method is rhinopneumometry. It is used to determine the volume of air that passes through the nasal cavity in a specific time. With hypertrophy, the volume of air entering the body is significantly reduced.

Therapy

Drug treatment is often ineffective. The therapeutic effect of drugs is short-term and weakly expressed. Long-term use of vasoconstrictor drugs (adrenergic agonists) leads to dryness of the mucous membrane. Discomfort appears - dryness, burning in the nose. Addiction to the drugs develops, the patient requires an increase in dosage and frequency of use of the drugs. As a result, the therapeutic effect is reduced. Obstruction (blockage) of the nasal passages is difficult to eliminate.

Main types of surgical treatment:

The indication for one or another method is the degree of hypertrophic damage and respiratory impairment. Manipulations take place under local or general anesthesia.

Cauterization is carried out using chemical compounds - 30-50% lapis (silver nitrate), chromic acid. Recently, it has been used rarely and only in the initial stages of hypertrophic degeneration.

The development of medicine has ensured the emergence of new powerful optical systems. With the help of endoscopes, it is possible to accurately perform surgical correction of hypertrophied nostrils, especially the poorly visible posterior parts of the nasal cavity. Thanks to gentle surgical intervention, minimal tissue trauma can be achieved.

Regeneration of the mucous membrane occurs in the shortest possible time. Clinical studies indicate rapid restoration of the ciliated epithelium while maintaining its functions. Precise surgical correction allows you to avoid post-traumatic complications - tissue atrophy.

Osteoconchotomy is the careful removal of part of the submucosal bone base of the inferior turbinate. Sometimes the above surgical interventions are combined with lateroposition - displacement of the turbinates to the side wall of the nasal cavity.

Some experts recommend septoplasty (straightening of the nasal septum) if there is a clear need. Important! During septoplasty, the surgeon must model a deviated septum from the same cartilage tissue.

During operations, analgesics, antiallergic drugs and anticholinergics are used (Promedol, Atropine sulfate, Diphenhydramine). A 1% solution of novocaine, 1-2% lidocaine, 0.5% ultracaine or trimecaine is used as a local anesthetic. Surgical treatment occurs in a hospital setting.

An outpatient ultrasound examination is performed - ultrasonic disintegration of the lower parts of the nasal turbinates. This treatment method is based on restoring the vasomotor ability of blood vessels. With the help of an ultrasonic waveguide - the Laura-Don-3 device - old sclerotic vessels are destroyed, which the body replaces with new ones. Their original ability to expand and contract is restored. If the operation is successfully performed, nasal breathing returns to normal within 3-4 days.

In the postoperative period, to reduce swelling of the mucous membrane, decongestants (decongestants) - Otrivin, Nazivin - are used as prescribed by the doctor. They also reduce the likelihood of complications.

In addition, rehabilitation includes the use of antibacterial and antihistamine (anti-allergic) agents (Cetrin, Zodak, Fenistil, Loratadine, Zyrtec, etc.), daily swabbing of the nostrils for 3-5 days. It is recommended to rinse the nose with nasal sprays based on sea or mineral water. They use “Aqua Maris”, “Dolphin”, “Aqualor”, “Rinorin”, “Marimer”.

Correctly administered drug treatment and successful surgery prevent perforation (opening) of the nasal septum. If its curvature is the cause of the development of hypertrophy, then the resulting pathology is reversible.

Author: Natalia Tsyurik

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    Hypertrophic and hyperplastic rhinitis: differences from the common runny nose, treatment methods

    Hypertrophic rhinitis is a chronic disease in which the mucous membranes and bone structures of the nasal passages grow. Pathological processes are irreversible and often become an indication for surgical intervention.

    However, in some cases, conservative treatment of the disease is carried out. If the development of pathology is recognized at the initial stage and proper treatment is carried out, surgery can be avoided.

    General information

    The initial stages of hypertrophic rhinitis are characterized by the proliferation of epithelial tissues lining the inferior turbinates of the nasal passages. As inflammation worsens, the tissues of the middle turbinates, periosteum and nearby bone structures are involved in pathological processes.

    Over time, hypertrophy turns into hyperplastic rhinitis - a stage at which the overgrown epithelium is replaced by connective tissue, followed by the formation of polyps and cysts.

    The overgrown ends of the turbinates can hang into the nasal cavity, which distinguishes hyperplastic rhinitis from other types of pathology. Also, the external tissues of the nose can be involved in the pathological process, while the organ greatly increases in size and its shape changes.

    The increase in tissue that accompanies hypertrophic and hyperplastic rhinitis causes constant congestion of the nasal passages, resulting in breathing problems. At advanced stages of the pathology, complete obstruction of the airways is noted.

    The disease develops for various reasons, including:

    • Constant exposure to tissues of infectious microorganisms (for chronic diseases of the ENT organs) or allergens, external factors (dust, chemical suspensions, low temperatures, etc.);
    • Diseases of the internal systems of the body (endocrine, nervous, immune, cardiovascular);
    • Congenital or acquired structural abnormalities (deformation of the nasal septum, narrowness of the nasal passages, proliferation of the peripharyngeal tonsil);
    • Uncontrolled long-term use of nasal drops or sprays with a vasoconstrictor effect;
    • Previously untreated catarrhal or vasomotor runny nose.

    Most often, hypertrophic rhinitis becomes a complication of a common runny nose in the absence of adequate therapy or long-term use of local vasoconstrictor drugs.

    Differences between hypertrophic rhinitis and a common runny nose

    The usual chronic runny nose (catarrhal) and hypertrophic rhinitis have a similar course - they develop without signs of acute inflammation. The patient's condition remains satisfactory - body temperature does not increase, there is no significant malaise. However, there are also distinctive signs by which one or another form of the disease can be recognized.

    In the catarrhal form, only inflammation of the mucous membrane of the nasal passages is noted, which is manifested by congestion, copious nasal discharge, sneezing, and increased runny nose in the cold. Immediately after instillation of vasoconstrictor drops, the patient’s condition improves and breathing is restored.

    The distinctive symptoms of chronic hypertrophic rhinitis are caused by the proliferation of inflamed tissues and constant disruption of nasal breathing. For hypertrophy:

    • The sense of smell deteriorates or is completely lost, the sense of taste is weakened;
    • The timbre of the voice changes, a characteristic nasality appears;
    • Hearing is impaired;
    • Periodic headaches are a concern (occur due to compression of blood vessels by overgrown tissue):
    • There is no rhinorrhea (mucus is produced in normal quantities or is not released at all, which leads to the development of “dry” congestion);
    • There is a constant feeling of dryness in the mouth and nasopharynx;
    • Instillation of vasoconstrictor drugs does not bring relief - breathing is not completely restored.

    Classification

    According to the localization of pathological changes, they are distinguished:

    The mucous membrane increases in certain areas of the nasal cavity.

    Hyperplasia is observed on almost the entire mucosa.

    The limited form can become diffuse, when individual inflamed foci grow and unite with each other.

    Most often, inflammation affects the mucous membranes of the inferior nasal concha. Which particular department is involved in pathological processes can be determined by the nature of the respiratory dysfunction:

    • Inflammation of the anterior section of the inferior turbinates is accompanied by difficulty in both inhalation and exhalation;
    • Damage to the posterior part of the inferior turbinates is characterized by a violation of only inhalation or exhalation.

    Depending on the nature of the structural changes, hypertrophic rhinitis is classified into:

    Hypertrophy is functional, caused by individual structural features - the accumulation of a large number of vessels in the tissues of the nasal cavity.

    Slowly progressive inflammation, characterized by irreversible proliferation of connective tissue.

    Accompanied by an increase and pronounced swelling of the nasal mucosa, which intensifies when exposed to various external and internal factors.

    There are signs of both fibrous and edematous forms.

    Diagnostic methods

    All forms of chronic runny nose have similar manifestations and the nature of the course of inflammatory processes, so an accurate diagnosis can only be made by an otolaryngologist after conducting instrumental research methods.

    To make an accurate diagnosis, the following is carried out:

    • Rhinoscopy;
    • Endoscopic examination of the nasal passages;
    • X-ray of the paranasal sinuses.

    These methods make it possible to study all areas of the nasal cavity, determine the location, degree and nature of hypertrophic changes. Additionally, the patient may be referred for rhinopneumometry to accurately determine the volume of air passing through the nasal passages and assess the functional state of the nose.

    Differential diagnosis of allergic and vasomotor rhinitis involves conducting a test with vasoconstrictor drops.

    Treatment of hypertrophic rhinitis

    Treatment of chronic hypertrophic rhinitis is carried out conservatively or surgically. The choice of the optimal method of therapy depends on the severity of the disease and the degree of damage to the tissues of the nasal passages.

    Traditional methods

    Conservative treatment can reduce the symptoms of the inflammatory process for some time.

    Vasoconstrictor local agents.

    (Tizin, Nazol, Nazivin, Galazolin) partially facilitate breathing in the initial stages of hypertrophic rhinitis. But since the drugs do not reduce tissue volume and do not stop proliferation, their use will soon have no therapeutic effect.

    Hormonal drops and sprays.

    (Nasonex, Avamis, Desrinit, Hydrocortisone suspension) have a pronounced anti-inflammatory effect, thereby reducing unpleasant symptoms. The positive effect of their use lasts several weeks or months, after which the symptoms resume.

    Saline solutions for rinsing the nose.

    (Salin, Humer, Marimer) alleviate the condition in cases where pathological processes arise or are aggravated when the mucous membrane is exposed to external factors - dust, aggressive chemicals. Nasal rinsing allows you to clear the nasal passages of foreign irritating particles.

    (Polydex, Isofra) are prescribed only if chronic inflammation is complicated by a bacterial infection.

    Physiotherapeutic treatments include:

    • Ultraviolet irradiation of the nasal passages;
    • UHF;
    • Massage of the mucous membranes using 20% ​​splenin ointment.

    Surgery

    Since structural changes in tissue are irreversible, conservative therapy is not always effective. In case of prolonged chronic inflammation that has affected the deep structures of the nose, the only effective method of treatment is surgery.

    For moderate hyperplasia, gentle techniques are used:

    Cauterization of overgrown tissues.

    Chromic or trichloroacetic acid and silver nitrate are used.

    Coagulation of blood vessels located under the mucous layer of the nasal cavity.

    Reduction of blood vessels under the influence of ultrasound.

    Cauterization of overgrown tissues using high-frequency current.

    In case of significant damage to the nasal tissue and significant impairment of respiratory function, deep surgical interventions are performed:

    Removal of overgrown areas of the mucous membrane.

    Removal of the inner lining of the nasal cavity along with bone elements.

    The operations are performed under general anesthesia and last up to half an hour. The use of modern endoscopic equipment allows the operation to be performed without damaging nearby healthy tissue, thereby significantly reducing the rehabilitation period. Already 4-7 days after surgery, the patient can return to their usual lifestyle.

    Folk remedies

    Treatment with folk remedies involves:

    • Rinsing the nasal passages with saline solution;
    • Rinsing the nose with decoctions and infusions of medicinal plants (chamomile, sage, mint, St. John's wort);
    • Inhalation of water steam with the addition of essential oils of mint, lemon, tea tree.

    It is important to understand that these remedies help make breathing a little easier, clear mucus from the nasal passages and reduce inflammation in the initial stages, but do not cure the disease.

    They should be used only after the approval of the attending physician. Independent use of remedies prepared according to traditional medicine recipes can cause aggravation of inflammatory processes in the nose.

    Hypertrophic rhinitis is a serious disease that is difficult to respond to conservative therapy. In order not to bring the situation to surgery, it is important to promptly treat a runny nose in acute respiratory infections and correctly use vasoconstrictor drugs for rhinitis.

    If nasal congestion and breathing problems persist for a long time, you should not hesitate to visit a doctor. Only a doctor will be able to recognize chronic inflammation in the early stages and select appropriate treatment.

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    Source: http://gaimoritus.ru/nasmork/gipertroficheskij.html

    Chronic hypertrophic rhinitis: treatment of hyperplasia of the nasal mucosa

    Prolonged hypothermia of the body, dust and gas pollution in the air, the presence of allergic particles or infectious irritants in it are factors leading to a serious chronic disease of the nasal turbinates, called hypertrophic rhinitis.

    It leads to uncontrolled growth of the tissues of the bone frame of the nose and its mucous membrane.

    It is impossible to cure hypertrophic rhinitis with medications alone.

    After all, this pathology causes irreversible changes in the nasal tissue and requires surgical intervention. It is impossible to completely restore the original appearance of the nose with drug treatment, but nevertheless, there are several ways in which the treatment of hypertrophied rhinitis can bring minor results without surgery.

    Causes of the disease

    The increase and proliferation of tissues of the nasal passages occurs with the involvement of the bone tissue of the nasal concha and their periosteum in the process. This is a serious pathological hyperplasia, which can be of two forms: diffuse and limited.

    Most often, chronic hypertrophic rhinitis affects the area of ​​the inferior nasal concha.

    The occurrence of this disease is a consequence of many factors, including not only air pollution and hypothermia, but also:

    1. Diseases of the cardiovascular system are a factor that is often followed by many other diseases, including rhinitis;
    2. Pathological conditions of the endocrine system;
    3. Abuse of vasoconstrictors. Very often, nasal drops and sprays are not taken with due seriousness; they are taken unreasonably and uncontrollably, without thinking about the consequences. But they are not so harmless, and incorrect and extreme use of these drugs leads not only to addiction, but also to serious complications;
    4. Presence of a deviated nasal septum. This may be a congenital defect, or it may be acquired. In any case, this pathology has a significant predisposition to hypertrophy;
    5. Pathological conditions of the neuro-reflex function of the nose;
    6. Untreated past rhinitis: vasomotor, chronic, catarrhal. Neglected treatment causes great harm. Remaining in the body for a long time, the infection wears out the immune system to zero, depriving the body of protection against many diseases.

    Often, the chronic form of rhinitis becomes the basis for the appearance of nasal hypertrophy. But the most common cause of this pathology is long-term, unprescribed use of vasoconstrictor medications. It should be remembered, no matter how safe the drug may seem, you should not take it without medical supervision. Self-medication can lead to irreparable consequences.

    Preventing hypertrophied rhinitis will help with timely treatment of acute forms of diseases of the ENT organs and not bringing them to the chronic stage. Moreover, it should exclude self-medication and excessive use of nasal drops and sprays.

    In addition, under no circumstances should you interrupt the course of treatment until complete recovery or change its components in any way. No matter how it may seem that the disease has receded and it has become much better, stopping taking medications before the final doctor’s appointment is fraught with consequences.

    Often, people suffering from rhinitis try with all their might to get rid of it without finding the main cause of its occurrence. After all, very often the cause is an allergy.

    And as a result, treatment, without eliminating the main factor of the disease, does not cure, but cripples.

    Diagnosis and symptoms of hypertrophic rhinopathologies

    The symptoms of various forms of rhinitis are very similar and only an ENT doctor can identify any specific one (vasomotor, hypertrophic, catarrhal). However, everyone should know the main symptoms of chronic rhinitis in order to identify it in time and seek medical help:

    • It is difficult to breathe through the nose due to constant congestion that does not go away. The patient is forced to breathe frequently through the mouth, which increases the risk of other diseases;
    • Copious mucous discharge appears, often mixed with pus. The nose literally “leaks”, and blowing your nose does little to eliminate this problem;
    • Severe headaches in the forehead and bridge of the nose. Also, pain can spread to other places, creating the illusion of “squeezing”;
    • The sense of smell decreases and it becomes difficult to recognize odors. In more complex cases, the patient may completely lose his sense of smell;
    • Hearing gets worse. Since all organs of the ENT system are interconnected, rhinitis also has a detrimental effect on the ears;
    • A nasal voice appears.

    When rhinitis passes from the chronic stage to the hypertrophied stage and processes of change in the mucous and bone tissue begin, the following symptoms appear:

    1. There is a sharp difficulty in bilateral nasal breathing due to alternate blockage of the nasal passages;
    2. It is difficult to either inhale or exhale: the nose is blocked in one of these options. For example, a patient can inhale freely, but it is no longer possible to exhale from the nose - as if something is interfering;
    3. The nose begins to run. The formation of mucus and nasal secretions increases;
    4. Voice changes may occur;
    5. Neoplasms compress the lymphatic gaps, which causes severe headaches.

    If urgent medical treatment is not started, the patient risks completely losing his sense of smell.

    Treatment of chronic hypertrophic rhinitis

    As already mentioned, drug treatment of hypertrophic rhinitis is not able to cope with uncontrolled changes in the tissues of the nose, but there is no need to rush to resort to surgical intervention.

    There are several more conservative methods to relieve acute symptoms of changes in the mucous membrane of the nasal passages. If therapy is followed, nasal hyperplasia can be stopped and uncontrolled growth of bone tissue will slow down.

    Mild symptoms will be relieved by one of the following methods:

    1. Irradiation of the nasal passages and nasal turbinates with ultraviolet light;
    2. UHF EP procedures;
    3. Massage the nasal mucosa using penin ointment;
    4. Introduction of Hydrocortisone into the mucous membranes of the nasal passages;
    5. Vasoconstrictor drugs - to improve the outflow of abundantly secreted mucus.

    But if the symptoms appeared a long time ago and treatment did not start for a long time, such conservative methods will no longer help. After all, the longer the treatment was delayed, the more the hyperplasia progressed. The changes in the mucous and bone tissue of the nose have become too profound, which, alas, has become irreversible, and in this case standard pills for the common cold will not help.

    In addition, physiotherapy, such as massage, will help more in the treatment of chronic rhinitis than in eliminating rhinopathology, but advanced hypertrophic rhinitis can only be treated surgically. These include:

    • Cauterization with chemicals;
    • Disintegration of lower shells with ultrasound;
    • Laser destruction;
    • Vasotomy.

    Of these, cauterization is considered the least effective and is rarely used in eliminating nasal hyperplasia. But, if the doctor is confident that such a gentle intervention will help, then cauterization can be successfully used.

    When changes in the mucous and bone tissue are already quite significant, accompanied by difficulty breathing and complete dysfunction of the nasal passages, more serious types of surgical intervention are prescribed:

    • Partial resection of the nasal concha;
    • Removal of the nasal mucosa (conchotomy);
    • Removal of the edge of the turbinate bone (osteoconchotomy).

    Surgical treatment is the most effective and fastest way in which hyperplasia of the mucous and bone tissue and hypertrophic rhinitis can be cured. If the patient does not have allergies, the operation is performed under local or general anesthesia. For this purpose, anticholinergic and antihistamine drugs, narcotic analgesics are used.

    With the help of modern equipment, hyperplasia is eliminated in ten or twenty minutes, and it is absolutely painless.

    Surgical treatment eliminates all symptoms of mucosal disorders and returns patients to normal life within a couple of days after surgery.

    Prevention of hypertrophic diseases of the nose

    Any disease, in the absence of proper and early treatment, threatens to develop into a chronic form or lead to serious complications. And catarrhal rhinitis is no exception. An untreated disease becomes chronic and then leads to irreversible changes in the mucous and bone tissues of the nose.

    Therefore, prevention of hypertrophy is very important, and it comes down mainly to timely drug treatment. Moreover, self-medication and experiments with medications are under no circumstances allowed.

    At the same time, it would be useful to strengthen the immune system: eating food rich in vitamins and minerals, carrying out hardening procedures, and sunbathing. Spend more time in the fresh air and avoid spending long periods of time in closed spaces full of dust and harmful gases.

    For allergy sufferers, it is necessary to take steps to eliminate allergens. About. How to cure chronic rhinitis in the video in this article.

    Source: http://stopgripp.ru/bolezn/rhinitis/gipertroficheskij-rinit.html

    hyperplasia of the nasal mucosa

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    Questions and answers on: hyperplasia of the nasal mucosa

    Frontal sinuses dimensions: on the right 31x44 mm, on the left 34x48 mm, normally developed, free and pneumatized, walls with smooth contours. The cells of the ethmoid sinus are clean throughout, the walls are clean, not thickened, without defects, there is no thickening of the mucous membrane.

    The main sinus measures 39x37x25 mm, with a coarse structure, its walls are clear, the integrity is not broken, there is no fluid or swelling of the mucous membrane.

    The maxillary sinuses are symmetrical, with smooth walls, aerated, without areas of bone destruction. In the left maxillary sinus, along the lower part of the wall, local mucosal hyperplasia is visualized, measuring 17x16x21 mm, density 6/41 HU, in the lower parts of which the tooth root is visualized.

    The nasal septum is curved to the left by 3 mm, in its middle sections there is a bone spike, which protrudes up to 3 mm, adheres to and slightly deforms the inferior nasal concha on the left, other nasal conchae are of the usual shape, not changed, the mucous membrane of the middle and inferior nasal concha on the right is swollen .

    CONCLUSION: MR signs of local mucosal hyperplasia in the left maxillary sinus, curvature of the nasal septum to the left. The examination protocol was also accompanied by a picture taken from different angles.

    On December 5, 2003, surgical treatment was performed in Kiev to straighten the nasal septum based on the recommendations of a specialist from the Institute. However, before the operation, the operating doctor did not pay attention to the tomography image and protocol.

    As a result of surgical intervention, nasopharyngeal discharge was not suppressed. Moreover, most of the doctors who examined me after that noticed a curvature of the nasal septum. When I said that I had undergone surgical treatment to straighten the septum, they were slightly perplexed. Since after the operation the symptom of the disease remained, I continued to do physical procedures and take medications as prescribed by the attending physician, but with the same result (i.e., with complete absence). On January 27, 2005, I again had a consultation at the Institute of Otolaryngology (Kiev) with the same specialist, who also spoke about a deviated septum and wanted to prescribe surgical treatment. When I said that treatment had already been carried out according to his conclusions, he was also surprised and recommended nasal swabs and antibiotic rinsing. After this, targeted treatment was not carried out. In August 2010, at the Institute of Otolaryngology, I again underwent puncture of the left maxillary sinus (third times when the symptom of the disease appeared), however, the result did not differ from the previous ones, and discharge from the nasopharynx continues to bother us to this day. How to recover? Sincerely. Alexey