What Is Empty Nose Syndrome?

Postnasal drip syndrome (PNDs) refers to chronic inflammation caused by allergic or non-allergic reactions in the nasal cavity and sinuses. Secretions from inflammation sites flow backward through the nasal cavity and enter the oropharyngeal area. Chronic cough is caused by long-term stimulation. It is a clinical symptom mainly characterized by the corresponding symptoms such as pharyngeal foreign body sensation and pharyngeal sticky sputum adhesion. It is a common cause of chronic cough in children in clinical.

Chinese name: Postnasal drip syndrome

Foreign name: Postnasal drip syndrome

Postnasal drip syndrome 1. Causes and common diseases:

(1) Cause:

1. Allergic inflammation in the nasal mucosa leads to a weakening of its ability to regulate temperature and humidity, which reduces the protective effect on the airways;

2. The nasal ciliary motor function and the function of removing foreign bodies are reduced, resulting in a high response state in the airway, and the symptoms of chronic cough due to the nasal and pulmonary reflex;

3. The inflammatory substances produced by allergic rhinitis and sinusitis cause the cough emission through the nasal inferior stream and the chronic cough symptoms appear.

(B) common diseases:

Common nasal diseases that cause PNDs include rhinitis, sinusitis, allergic rhinitis, and adenoid hypertrophy.

Postnasal drip syndrome 2. Differential diagnosis:

Refer to the diagnosis points of PNDs in the Guidelines for the Diagnosis and Treatment of Chronic Cough in Chinese Children:

1. Sexual cough with or without sputum, morning cough and change of body position, mostly with nasal congestion, runny nose and dry throat, clearing throat, sticky sputum adhesion, backflow of mucus into the nose or throat , A small number of children may be accompanied by headache, dizziness, low fever, etc .;

2. Examination of the sinus area may be accompanied by tenderness, secretions at the opening of the sinuses, and follicles in the posterior wall of the pharynx may be cobblestone-like, or mucus may be attached to the posterior wall of the pharynx.

Postnasal drip syndrome 3. Inspection:

1. Postnasal drip syndrome 1. Nasal examination:

Swelling of the mucous membrane can cause narrowing of the nasal cavity, secretions of different nature in the nasal passages, and drainage to the nasopharynx, or although there is no obvious abnormal nasal manifestation, obvious inflammation reactions, tumors and viscous secretions are present .

2. Postnasal drip syndrome 2. Nasopharyngeal endoscopy:

Redness, swelling and congestion of mucous membranes, mucus attachment, and swelling and congestion of the pharynx were seen.

3. Postnasal drip syndrome 3. Oropharyngeal examination:

It can be seen that the mucus or mucopurulent secretions draining down from the nasopharynx show chronic inflammation, lymphoid follicle hyperplasia, tonsil hypertrophy, and chronic inflammation changes.

4.XCT Postnasal drip syndrome 4. X-ray or CT scan of the sinuses:

Chronic sinusitis manifestations were found, such as thickened nasal mucosa, blurred nasal cavity, and mucus in the sinuses.

Postnasal drip syndrome 4. Principles of treatment:

It is mainly for the treatment of various causes of PNDS.

1. The principle of treating acute nasal cavity and sinus inflammatory diseases is anti-infection, improving nasal congestion, opening the sinus opening, promoting drainage and reducing inflammation. The main treatment of acute sinusitis is the application of antibacterial drugs. When the effect is not good or the secretions are large, glucocorticoids and decongestants can be used to reduce inflammation.

2. The treatment of chronic rhinosinusitis can generally adopt the following initial treatment plan: apply antibacterial drugs effective for Gram-positive bacteria, Gram-negative bacteria and anaerobic bacteria for 3 weeks; nasal decongestants for 1 week; nasal inhaled glucocorticoid 3 months.

3. Postnasal drip syndrome caused by allergic rhinitis is effective with various antihistamines, and the second-generation antihistamines without sedation are preferred. Nasal inhaled glucocorticoids are also the drug of choice for allergic rhinitis. Improving the environment and avoiding allergen stimulation are effective measures to control allergic rhinitis. Allergen immunotherapy may be effective, but the onset time is longer.

4. Sinusitis is ineffective in conservative treatment and functional nasal endoscopy can be performed in patients with nasal polyps to remove lesions and promote the recovery of physiological functions of the affected mucosa by reconstructing the ventilation and drainage of the nasal cavity and sinuses.