Radiofrequency is a safe and effective way to treat enlarged turbinates! The inferior turbinate hypertrophy will cause nasal congestion, conventional drug treatment effect is not good. Currently there are many ways to reduce the size of the inferior turbinate, such as: total or partial excision of the inferior turbinate, electrocautery, cryotherapy, laser therapy. Although these methods are effective, but due to the surface of the turbinate mucous membrane damage, often appear nasal cavity adhesion, dryness, bleeding. Radiofrequency can overcome the shortcomings of other therapies by forming thermal damage under the mucous membrane without destroying the surface mucous membrane. After the operation, nasal congestion was found to be significantly improved, the volume of inferior turbinate was reduced, the frequency of ciliary oscillation was not significantly different from the basal value, and the ciliated cells were still the most numerous cells in the nasal mucosa after the operation.
Chronic rhinitis is a chronic inflammation of the nasal mucosa that is dominated by nasal congestion, and it includes both chronic simple rhinitis and chronic hypertrophic rhinitis.
Any factor that continuously stimulates the nasal mucosa, affects the function of nasal mucus cilia clearance, and increases nasal breathing resistance can trigger chronic rhinitis. Such as working in a polluted environment for a long time, exposure to harmful gases, dust, etc.; or because of acute rhinitis recurrence, treatment is not complete; or long-term inappropriate use of the nasal eye net, etc. can cause chronic rhinitis.
Chronic rhinitis is not difficult to diagnose, treatment should pay attention to avoid the harmful factors that cause this disease, pay attention to strengthen the body, choose the appropriate nasal drops. Chronic hypertrophic rhinitis can be injected with sclerosing agent under the mucous membrane of the hypertrophied inferior turbinate, or with laser or cryotherapy, so that the inferior turbinate shrinks to facilitate nasal ventilation and drainage.
Prescription
1. Strengthen labor protection, avoid or reduce exposure to harmful gases and dust.
2. When suffering from acute rhinitis, you should pay attention to rest and active treatment. Usually pay attention to strengthen the physical exercise.
3. Chronic simple rhinitis can use 1% ephedrine nose drops, pay attention to grasp the method of nose drops.
4. Do not use long-term nasal eye net.
5. Surgery of inferior turbinate should be cautious, because excessive resection can induce atrophic rhinitis.
Chronic rhinitis is a chronic inflammation of the mucous membrane and submucosa of the nasal cavity caused by systemic, local or occupational factors. It usually includes chronic simple rhinitis and chronic hypertrophic rhinitis. The clinical features of chronic simple rhinitis are alternating and intermittent nasal congestion, and abundant snot, often mucous snot. The clinical features of chronic hypertrophic rhinitis are severe nasal congestion, mostly persistent, not much nasal mucus, more viscous, not easy to blow out. When chronic rhinitis is severe, it can affect the olfactory function.
Nutritional guidelines:
I. Increase physical exercise, choose medical health exercises, tai chi, five birds play, play table tennis, sword dance and other projects, persistent, can enhance physical fitness, improve the body's ability to resist disease. From the beginning of summer, insist on using cold water to wash the face and wipe the nose, increase the ability to withstand the cold. When it is cold or when the climate changes drastically, you should avoid getting cold, prevent colds, and wear a good mask when you go out. Try to find out the causative factors, timely prevention and treatment.
II. Nasal congestion should not be forced to blow the nose, so as not to cause nasal capillary rupture and nosebleed, can also prevent the bacterial mucus back into the nasopharynx complicating otitis media.
Three. The use of self-nasal massage techniques, with the index finger and middle finger of both hands at the same time massaging the inner corner of the eyes at the bridge of the nose, from the top to the bottom of the 1 time, ***80 times; with the middle finger rubbing in the nose on both sides of about 1 centimeter, for a rotating massage, ***70 times; index finger, middle finger, ring finger of both hands at the same time massaging the center of the eyebrow, and then massaged outward along the eyebrow to the two sides of the solar plexus, ***60 times. Can be repeated massage, morning, noon and night once. Can effectively prevent the occurrence of rhinitis and improve the condition of chronic rhinitis.
Four. Use warm water to wash the nasal crusts, and then dip a cotton swab in raw honey coated nasal cavity, once a day, until the nasal cavity without pain, no secretion crusts, sense of smell restored.
V. Diet should be easy to digest and absorb food. Avoid eating cold, smoke, alcohol, pungent and dry stimulating products.
VI. The first thing you need to do is to take care of the acute rhinitis.
Chronic rhinitis is a common disease with nasal congestion and runny nose. If you breathe through your mouth when your nose is blocked, the respiratory tract door is open and it is easy to get infected with diseases. Therefore, chronic rhinitis should also be taken seriously and actively treated.
Chronic rhinitis, due to repeated episodes of acute rhinitis and improper treatment, gradually evolved.
Localized lesions such as deviated nasal septum, enlarged nasal turbinates and nasal polyps, as well as chronic lesions in neighboring organs such as chronic tonsillitis and sinusitis are prone to chronic rhinitis. In addition, long-term work in a dusty, hot, dry environment, or long-term exposure to harmful gases, as well as a lack of exercise, poor adaptability to climate change, vulnerable to colds and flu people, are prone to chronic rhinitis.
There are also some chronic diseases, such as heart disease, liver disease, tuberculosis, kidney disease, severe anemia, vitamin deficiency and other patients, because the nasal mucosa is often in a state of congestion or malnutrition, but also easy to combine chronic rhinitis.
Chronic rhinitis usually includes chronic simple rhinitis and chronic hypertrophic rhinitis. Symptoms of chronic simple rhinitis are characterized by nasal congestion and increased nasal discharge, often accompanied by smell disorders and headaches. Nasal congestion is mostly intermittent and alternates between the two sides. The symptoms of chronic hypertrophic rhinitis are heavier than those of simple rhinitis. Nasal congestion is mostly persistent, with significant loss of smell, and hypertrophy of the posterior end of the inferior turbinate can compress the pharyngeal opening of the Eustachian tube, causing tinnitus and hearing loss. Due to frequent open-mouth breathing and the stimulation of secretions, inflammation of the pharynx is very likely to occur, with symptoms such as dryness and cough. In addition, headache, insomnia, memory loss, mental depression, etc., are also common symptoms.
The treatment of chronic rhinitis, first of all, should be identified systemic, local and environmental factors related to pathogenicity, timely treatment or elimination. Local vasoconstrictor available, such as 0.5 ~ 1% ephedrine saline drops, can also be used for a short period of time, such as nasal eye drops. Acupuncture therapy can take Yingxiang, Hegu and other points. Closure therapy can be used 0.25-0.5% procaine to do the above points closed, can also be used for the nasal mound or the mucosal closure of the anterior end of the inferior turbinate. When the secretion is too sticky and difficult to eliminate, warm salt water can be used to rinse the nasal cavity. For inferior turbinate hypertrophy, local medication can not work, can be frozen or carbon dioxide laser vaporization treatment. If it is still ineffective, partial resection of the middle and inferior turbinates can be considered.
Prevention of chronic rhinitis, need to exercise, enhance the body's ability to defend. At the same time, should pay attention to diet and environmental hygiene, quit smoking and alcohol, treatment of systemic diseases, correction of nasal deformity, remove the lesions near the nasal cavity. Some drugs such as lisdexamfetamine and estrogen-containing contraceptives can cause nasal mucosal congestion, and it is advisable to replace them with other drugs.
Treatment, do not abuse the nasal vasoconstrictor, generally 2 to 3 times a day drops, to minimize the use of the principle of young children should be used with caution. If a large number of long-term use, can cause drug rhinitis, once the occurrence of the drug should be discontinued immediately, change to saline nasal drops, or 25% hydrocortisone acetate nasal drops, the condition can be expected to gradually reduce.
What is the concept and cause of chronic rhinitis?
Chronic rhinitis refers to the inflammation of the nasal cavity under the mucous membrane lasts more than a few months, or inflammation recurrence, in the intermittent also did not return to normal, and there is no obvious pathogenic microbial infection. Clinically, chronic rhinitis is divided into chronic simple rhinitis and chronic hypertrophic rhinitis two types, but the two histologically can not be completely separated, there is a transition type, and chronic hypertrophic rhinitis from chronic simple rhinitis development.
The exact cause of chronic rhinitis is not known, but it is related to the following factors:
1, local factors
(1) repeated episodes of acute rhinitis or incomplete treatment;
(2) the long-term effects of chronic nasal and sinus diseases: such as chronic purulent sinusitis patients whose nasal mucosa due to long-term stimulation of pus; severe septal deviation impedes nasal ventilation and drainage, so that nasal mucosa easily drainage, so that the nasal mucosa is susceptible to recurrent infections and is not easy to recover completely;
(3) the influence of neighboring foci: mainly inflammatory foci, such as chronic tonsillitis, adenoid hypertrophy, etc.;
(4) inappropriate nasal use of medication or use of medication for too long: such as the long-term application of nasal drops or ephedrine, vasodilatation, mucosal swelling, resulting in pharmacological rhinitis; Lidocaine, dicaine can be detrimental to the mucosal cilia of the nasal mucosa. Nasal mucosa mucus cilia transport function.
2, systemic factors
(1) chronic systemic diseases: such as anemia, diabetes, rheumatism, tuberculosis, heart, liver, kidney disease, and plant nervous system dysfunction and chronic constipation, etc., can cause long-term vascular stasis or reflex congestion of the nasal mucosa;
(2) nutritional deficiencies: such as the lack of vitamin A, vitamin C;
(3) endocrine Disorders: such as hypothyroidism can cause nasal mucosal edema; pregnancy and lactation nasal mucosa is often physiological congestion and swelling;
(4) such as tobacco and alcohol addiction
3, occupational and environmental factors: long-term or repeated inhalation of dust (such as cement, coal dust, flour, etc.) or for the harmful chemical gases (such as SO2, formaldehyde, etc.), the living or production environment, the rapid changes in temperature and humidity (such as steelmaking, coal dust, flour, etc.). Changes in temperature and humidity in the living or production environment (such as steelmaking, baking and melting, freezing operations) can lead to the disease.
4, the occurrence of this disease is also related to individual immune dysfunction and allergic reactions.
What are the main signs and symptoms of chronic simple rhinitis?
The symptoms of chronic simple rhinitis are nasal congestion and increased nasal discharge, and there is often a sense of smell and headache. Nasal congestion is mostly intermittent and alternating, sometimes persistent, and is heavier on the lower side when lying on the side. Nasal congestion is often relieved after exercise or in fresh air, and is aggravated when sitting still for reading, arithmetic or manual work. Heavy nasal congestion can lead to occlusive nasal sounds, decreased sense of smell and headache, sometimes causing inability to concentrate persistently and insomnia. The secretion increases, usually in the form of thick translucent mucus, occasionally accompanied by a little pus. Long-term irritation of the nasal vestibule and the skin of the upper lip caused by nasal vestibulitis, eczema or folliculitis, which is more common in children. The nasal mucus flows backward into the throat, which can cause nasopharyngitis and otitis media, and the patient has aspiration sputum and hearing loss.
Examination reveals bilateral inferior turbinate swelling, smooth and moist surface, dark red. In the elderly and weak, anemia, hypothyroidism, only swelling is seen without congestion. The mucosa of the inferior turbinate is soft and elastic, which is depressed when touched with a probe, and can be restored to its original state immediately after removing the probe. The nasal cavity is not easily visualized because of the swelling of the mucosa, and only viscous secretions can be seen between the inferior turbinate and the nasal septum and the floor of the nose. The nasal mucosa responds well to vasoconstrictors.
Chronic simple rhinitis is bilateral, without ulceration, granulation, necrosis, malodor, paroxysmal sneezing and watery secretion, and can be distinguished from other rhinitis. Prognosis is generally good, after appropriate treatment can be cured, nasal mucosa can be returned to normal. However, if the causative factors are not removed or improper treatment, the disease can evolve into hypertrophic rhinitis.
How should chronic simple rhinitis be treated?
The principle of treatment for chronic simple rhinitis is to eradicate the cause of the disease and restore the ventilation function of the nasal cavity, and the main treatment measures can be taken in the following aspects.
(1) Treatment for the cause: seriously find out the cause of the systemic or local pathology, timely treatment, but also pay attention to the protection of the environment, improve labor conditions, strengthen physical exercise, enhance physical fitness, improve the body's resistance.
(2) local treatment:
① nasal secretion viscous, available 9% of the saline rinse nasal cavity, so as to avoid the long accumulation of secretion and infection.
② Application of vasoconstrictor nasal drops: usually available 0.5% to 1% ephedrine saline, also available nasal drops, but can cause drug rhinitis and exacerbate nasal congestion, it must be considered.
③ Closure therapy: 0.25% to 0.5% procaine can be used for the Yingxiang, nasal through the closed points, can also be done in the nasal dike or submucosal injection of the anterior end of the inferior turbinate, each time 1 ~ 1.5 ml, every other day, 5 times for a course of treatment.
(3) Chinese medicine diagnosis and treatment: Chinese medicine called this disease "nose stifling", that its condition belongs to the lung meridian heat and lung spleen qi deficiency. The treatment is as follows: ① Lung meridian heat: nasal congestion is light and heavy at times, or alternating blockage, yellow and sticky mucus, small amount of mucus, hot nasal gas, swollen turbinates, good contraction response, yellow and sticky mucus in the nasal passages; red tongue with yellow moss and number of pulses. Treatment is to clear and promote lung-heat, activate blood circulation and clear the orifices. ② Lung, spleen and qi deficiency: nasal congestion is mild or alternating episodes, white sticky runny nose, or clear and thin, aggravated by wind and cold. Examination of the nasal mucosa can be seen pale white or reddish swelling, hypertrophy of the nasal turbinates, loss of smell, may be accompanied by dizziness, bad wind, easy to catch a cold; tongue pale moss white veins fine. The treatment is to tonify the lung and spleen, dispel cold and clear the orifices. Square with tonifying the middle and benefit qi soup and cang erzi scattered plus reduction: astragalus 30g, party ginseng 15g, atractylodes 12g, angelica 12g, chaihu 10g, ascending flax 10g, chenpi 12g, poria 20g, gui zhi 10g, auricularia 10g, 10 g xin yi, dahuricae dahuricae 20g, peppermint 12g, platanthera 10g, licorice 6g. decoction of water to be taken internally. Externally, use Rhinitis Ling Nose Drops (see Q108), 2 drops each time, 3 times a day. Can also be used goose not to eat grass 50g, camphor 6g, *** research fine surface, bottle sealing, with medicine cotton wrapped in the nose, change the medicine 1 time a day.
(4) acupuncture: take Yingxiang, Hegu, on the star point; headache with Fengchi, Sun, Indo, medium stimulation, leave the needle for 15 minutes, once a day or every other day.
What are the clinical manifestations and treatment of chronic hypertrophic rhinitis?
Chronic hypertrophic rhinitis is a chronic inflammation of the nasal cavity characterized by limited or diffuse hypertrophy of the mucosa, submucosa and even bone. Its nasal mucosa long-term congestion and edema, followed by fibrous tissue hyperplasia, mucosal hypertrophy, sometimes osteochondral proliferation, nasal turbinate bone is substantial hyperplasia. Generally the inferior turbinate is the heaviest, the inferior turbinate anterior and posterior end and the lower edge, as well as the anterior end of the middle turbinate, can be nodular or mulberry-like hypertrophy or polypoid changes.
The clinical manifestations of chronic hypertrophic rhinitis are: heavy nasal congestion, mostly persistent, with occlusive nasal sounds, and decreased sense of smell. Nasal discharge is not much, mucous and mucopurulent. If the posterior end of the hypertrophied inferior turbinate compresses the pharyngeal opening of the Eustachian tube, tinnitus and hearing loss can occur. Due to open-mouth breathing and long-term stimulation of secretions, chronic pharyngolaryngitis, headache and dizziness, insomnia and dreaming, mental depression can easily occur. Examination shows hypertrophy of mucosa and turbinate, uneven surface of nasal mucosa, nodular or mulberry-like, pale, light red or purplish red. There is a hard solid feeling on palpation, and there is no depression when pressed. The mucosa may be depressed but not easy to recover immediately. With ephedrine, the mucosa does not contract or contracts very little.
The treatment of chronic hypertrophic rhinitis, in addition to the treatment of the cause of the disease, the following methods are applied to reduce the size of the nasal turbinates and to relieve symptoms such as nasal congestion.
(1) Submucosal sclerosing agent injection in the inferior turbinate.
Applicable to early hypertrophic rhinitis, commonly used drugs are 80% glycerol or 20% sulfathiazona, or 50% glucose solution, or 5% sodium cod liver oil acid. After surface anesthesia, the injection needle is stabbed backward into the submucosa from the anterior end of the inferior turbinate to the point close to the posterior end of the inferior turbinate, and then the needle is slowly withdrawn, and the sclerosing agent is injected while withdrawing the needle, and the injection volume is about 1ml. According to the contraction of the inferior turbinate 2 to 10 days later can be repeated injection, usually 3 times for a course of treatment.
The injection of sclerosing agent should pay attention to: ① suitable thickness of the injection needle, too thick easy to cause bleeding, too thin oil drug is not easy to inject. Injections, such as back to the blood, should be changed to the injection site. ② The amount of injection is not easy to make the mucous membrane is not too much, to the extent that the mucous membrane whitening, so as not to cause mucosal necrosis. ③ If systemic reaction occurs during injection, the injection should be stopped immediately and the patient should be made to lie down with the head slightly lowered. ④ To prevent blindness or visual impairment due to retinal arterial spasm, a rapid vasodilator such as isoamyl nitrite should be prepared.
(2) Submucosal electrocoagulation of the inferior turbinate: high-frequency current is used to coagulate the hypertrophied tissue, causing scar contraction. After surface anesthesia, a fine needle is used to pierce into the mucosa several times successively at the anterior end of the inferior turbinate, reaching the posterior end of the inferior turbinate from the front to the back without touching the bone, and then coagulation is performed while withdrawing the needle.
(3) cryotherapy: the head end of the high-pressure oxygen freezer, (-50 ℃ ~ -60 ℃) placed in the inferior turbinate hypertrophy for about 2 minutes; such as the use of liquid nitrogen freezer, because the temperature can be reduced to a lower temperature, the time should be shortened accordingly. When freezing, pay attention to complications such as pain, swelling, adhesion.
(4) Simple inferior turbinate mucosal resection: the patient takes a sitting position or semi-recumbent position, with 1% dicaine to do nasal surface anesthesia, and in the inferior turbinate mucosa injected with a small amount of 1 ‰ epinephrine 1% lidocaine 1 ~ 2 ml, with the turbinate scissors according to the scope of the booking of the excision of the inferior turbinate lesions of the mucosa. The resected hyperplastic tissue was removed, hemostasis was achieved with epinephrine cotton pads, and the nasal cavity was then filled with petroleum jelly gauze.
(5) Hypertrophic mucosa together with bone: the method is more or less the same as that of simple mucosal lesion excision, the difference is that a part of the turbinate bone will be excised.
The scope of resection in principle does not exceed 1/3 of the inferior turbinate, such as resection of too much, there is the possibility of secondary atrophic rhinitis. Partial resection of the inferior turbinate should pay attention to the contraindications: ① acute inflammation of the upper respiratory tract; ② hemorrhagic disease or hemorrhagic qualities; ③ menstruation; ④ hypertension, heart disease, cirrhosis of the liver, chronic nephritis, and other serious systemic diseases.
The Chinese medicine believes that this disease belongs to the category of "nasal stifling". Its pathogenesis is mostly related to the evil poison for a long time, stagnation of qi and blood stasis. The symptoms are swollen and enlarged nasal turbinates, hard and dark, or mulberry-like, or nodular, nasal congestion continues to aggravate, snot more yellow and thick or white viscous, smell loss, poor speech, cough and phlegm, tinnitus; tongue red with petechiae, pulse is fine. Treatment should harmonize qi and blood, remove stagnation and eliminate blood stasis. The formula is Blood Palace and Blood Stasis Soup plus reduction: angelica 12g, red peony 15g, raw rhizoma 15g, rhizoma rhizoma 15g, rhizoma rhizoma 15g, peach kernel 10g, safflower 10g, Chaihu 10g, Platycodon grandiflorus 10g, citrus aurantium dulcis 10g, xinyi 10g, zhoujia 15g, turtle shells 15g, houli 12g. Decocted with water and taken internally. External use of rhinitis spirit nasal drops long-term nasal drops. Compound Danshen injection or angelica injection can also be used for submucosal injection of the inferior turbinate, according to the conventional surface anesthesia, take 2ml of angelica injection, inferior turbinate injection, once every 2 days, 3 times for a course of treatment.
Why does chronic hypertrophic rhinitis cause hearing loss?
From the point of view of anatomical location, the nose and the ear are connected through the Eustachian tube. The Eustachian tube is located in the lateral wall of the nasopharynx, about 1 to 1.5 cm from the posterior end of the inferior turbinate, so the inferior turbinate is often caused by swelling or hypertrophy nasal congestion, which affects the ventilation and drainage of the Eustachian tube, resulting in tinnitus and hearing loss and other ear symptoms.
Under normal circumstances, the Eustachian tube has the function of regulating the air pressure in the middle ear through the opening and closing of the lumen of its cartilaginous section, so that it can maintain a basic balance with the external atmospheric pressure. At the same time, through the Eustachian tube mucous membrane cilia movement, can make the secretion from the middle ear to the nasopharynx discharged, so that the middle ear to play the role of drainage.
Chronic hypertrophic rhinitis caused by turbinate hypertrophy, the Eustachian tube pharyngeal opening is blocked, the outside air can not enter the middle ear, the original gas in the middle ear is gradually absorbed by the mucous membrane, the formation of negative pressure in the cavity, the mucous membrane of the middle ear is swollen, the permeability of the capillaries increases, the mucous membrane of the middle ear undergoes a series of pathological changes, the cupular cells increase, increased secretion, formation of tympanic cavity effusion, hindering the conduction of sound waves, thus causing hearing The hearing is gradually decreasing.
So, chronic hypertrophic rhinitis can cause hearing loss.
Chronic rhinitis
Chronic rhinitis is a chronic inflammation of the mucous membrane and submucosa of the nasal cavity. Manifested as chronic congestion and swelling of the nasal mucosa, called chronic simple rhinitis, if the development of the nasal mucosa and turbinate hyperplasia hypertrophy, called chronic hypertrophic rhinitis. The main causes include repeated episodes of acute rhinitis or treatment is not complete and evolved into chronic rhinitis, chronic inflammation of the neighboring such as sinusitis, tonsillitis and other long-term stimulation or deformity, improper use of nasal medication caused by medication rhinitis (common after a long time to use nasal drops), etc., in addition to systemic causes such as long-term chronic diseases, vitamin A or C deficiency, excessive smoking and alcohol, and long-term use of rifampicin and other antihypertensive medications and environmental pollution may be cause this disease. The main manifestation of nasal congestion, nasal discharge and other symptoms, hypertrophic rhinitis can be manifested as persistent nasal congestion, simple rhinitis for intermittent nasal congestion.
Guidance:
1, pay attention to self-treatment health care for their own causes.
2, to solve the problem of nasal congestion, 1% ephedrine or furacilin ephedrine solution, chloramphenicol ephedrine solution nasal drops, 3 times a day.
3, available 0.25 ~ 0.5% procaine for nasal mound closure or submucosal closure of the inferior turbinate, 1 ~ 1.5 ml each time, every other day, or twice a week, 5 times for a course of treatment.
4, nasal congestion can be used when the heavy sclerosing for the inferior turbinate injection therapy, or the use of laser microwave coagulation therapy. Among them, microwave and laser treatment is commonly used in clinical practice.
5, surgical therapy, mainly for bony hypertrophic rhinitis, can do partial resection of the inferior turbinate.
6, nasal drip method: the patient lying in bed. Head on the edge of the bed down, and the body at an angle of 90 degrees, drops into the nose, each side can be 2-3 drops, etc., to be about 3 minutes after getting up, which can prevent the nasal cavity into the pharynx. The elderly should not take and the method.