How Do I Choose the Most Effective Sinusitis Treatment?

Rhinitis is an inflammatory disease of the nasal cavity. It is an inflammation of the nasal mucosa caused by viruses, bacteria, allergens, various physical and chemical factors and certain systemic diseases. The main pathological changes of rhinitis are hyperemia, swelling, exudation, hyperplasia, atrophy or necrosis of the nasal mucosa.

Basic Information

English name: rhinitis
Visiting department: ENT
Multiple groups: Young, old and infirm

Common causes: Viral infection as the primary cause, or secondary bacterial infections based on this
Common symptoms: Nasal congestion, runny nose, decreased sense of smell, headache, dizziness, etc.
Contagious: no

Causes of rhinitis

Virus infection

Viral infection is the primary cause, or secondary bacterial infections are based on viral infections. More than 100 viruses are known to cause this disease. The most common are rhinoviruses, followed by influenza and parainfluenza viruses, adenoviruses, coronaviruses, coxsackie virus, and mucus and paramyxoviruses. The virus is mainly transmitted through the respiratory tract, followed by entering the body through contaminated bodies or food.

2. Genetic factors

People with a family history of allergies are susceptible to the disease. Most of the family members of the patients had a history of asthma, urticaria or drug allergies. This patient has been called atopic individuals in the past, and their ability to produce IgE antibodies is higher than that of normal people. However, in recent years, it has been found that there is no significant difference in the incidence of twins and the general population.

3. Susceptibility to nasal mucosa

Susceptibility arises from the constant stimulation of antigenic substances, but the degree of susceptibility depends on the number of mast cells and basophils in the nasal mucosa and the ability to release chemical mediators. It has been confirmed that the number of the above cells in the nasal mucosa of patients with allergic rhinitis is not only higher than that of normal people, but also has a strong ability to release chemical mediators.

4. Antigen substances

The antigenic substance that stimulates the body to produce IgE antibodies is called an allergen. The allergen substance enters the nasal mucosa again, and then combines with the corresponding IgE to cause an allergic reaction. The allergens that cause this disease are divided into two categories, inhalation and food, according to the way they enter the body.

(1) Inhaled allergens Pollen is not the cause of disease in all plants. Only those pollen that has a large amount of pollen, a large area of vegetation, strong allergenicity, and is transmitted by the wind are most likely to become allergens . Due to the differences in vegetation species, pollen with allergenicity varies in different regions. Fungi are widely distributed in nature, mainly in soil and rotten organic matter. The mycelia and spores are allergenic, but the spores are stronger. House dust mite belongs to the arthropod order Arachnida. Adults usually have a size of 300-500 m. It is mainly parasitized in every corner of the living room. Among them, mattresses, pillows, and sofa cushions are the most dusty. Mite excrement, eggs, desquamation, and its broken limbs can allergens. Animal dander Animal dander is one of the strongest allergens. Susceptible individuals can be sensitized if they have been in contact with the animal for a long time. After sensitization, even small amounts of dandruff can trigger nasal symptoms. Indoor dust is one of the common allergens that cause perennial rhinitis.

(2) Ingestive allergens refers to allergen substances that enter the body from the digestive tract and cause nasal symptoms. The manner in which it acts on the nasal mucosa is very complex and remains unclear to this day. Milk, eggs, fish and shrimp, meat, fruits, and even certain vegetables can be allergens.

Clinical manifestations of rhinitis

Symptoms

(1) Nasal congestion is characterized by intermittent. The nasal congestion is reduced during the day, hot weather, labor or exercise, and the nasal congestion is worsened at night, when sitting or cold. Another feature of nasal congestion is alternation. For example, when lying on the side, the nasal cavity on the lower side is blocked, and the upper nasal cavity is well ventilated. Due to nasal congestion, there may be symptoms such as decreased smell, headache, dizziness, and occlusive nasal sounds.

(2) Runny is often mucus or purulent, occasionally purulent. More purulent than after secondary infection.

(3) The decrease of olfactory is caused by two reasons, one is swollen nasal mucosa, nasal congestion, and airflow cannot enter the olfactory area; the other is that the olfactory area mucosa is stimulated by chronic inflammation for a long time, and the olfactory function is reduced or disappeared.

(4) Headache and Dizziness Chronic sinusitis usually manifests as a heavy head.

(5) Whole body performance Most people also have headaches, loss of appetite, fatigue, memory loss and insomnia.

2. Types of rhinitis

There are many types of rhinitis symptoms. Depending on the type of rhinitis, the symptoms of rhinitis are also different:

(1) Chronic rhinitis. Long-term intermittent or alternating nasal congestion can cause dizziness and brain swelling, which seriously affects sleep, work and study. A purulent snot often flows back into the pharynx, causing cough and sputum.

(2) Acute rhinitis In the first 1 to 2 days. Patients often have general malaise, chills, fever, loss of appetite, and headaches. Nasal cavity and nasopharynx dry, burning sensation, itchy nose, frequent sneezing. Acute period: 2 to 5 days. Existing symptoms worsened. Adult body temperature is about 38 degrees, children up to 39 degrees, often due to high fever vomiting, diarrhea, coma and even convulsions.

(3) Drug-induced rhinitis Long-term use of various rhinitis drugs or lasers and surgery that damage the nasal mucosa leads to persistent nasal congestion in the nasal cavity and frequent nosebleeds.

(4) Atrophic rhinitis The respiratory odor, nasal secretions are massive, tube-shaped pustules, and it is not easy to exudate. When you pull out the dried up, there is a small amount of nosebleeds. It is often mistaken for the initial rhinitis of a cold.

After the weather turned cold, some patients continuously sneezed, runny nose after getting up in the morning, and nasal congestion when there was a large temperature difference. They mistakenly thought that they had a cold and took some cold medicine, which caused their illness to worsen.

Rhinitis examination

Anterior rhinoscopy

The nasal mucosa is congested and swollen, and the inferior turbinate is congested and swollen. There are more secretions in the total nasal passage or the nasal floor. The initial water sample gradually becomes mucus, purulent or purulent.

2. X-ray nasolacrimal duct radiography

The presence or absence of sinus infection was clarified.

3. Nasal secretion smear to detect pathogenic bacteria.

4. Bacterial culture of nasal secretions + drug sensitivity.

5. If necessary, virus inspection requires special cultivation, isolation and identification.

Rhinitis diagnosis

According to the alternating and intermittent characteristics of nasal congestion, combined with clinical examination, diagnosis is not difficult.

Differential diagnosis of rhinitis

Hypertrophic rhinitis

Persistent nasal congestion is usually heavy, nasal discharge is not much, and it is mucus or purulent. Generally, there are headaches, dizziness, and hyposmia of varying degrees.

2. Allergic rhinitis

The degree of nasal congestion varies, and it occurs suddenly. The nose is thin and abundant, often accompanied by itching and frequent sneezing.

3. Angiomotor rhinitis

Symptoms are similar to variant rhinitis, with sudden onset and rapid resolution. There are obvious predisposing factors.

4. Flu

Severe systemic symptoms, such as high fever, chills, headache, joint pain in the whole body and muscles, etc. Upper respiratory symptoms are not obvious.

5. Acute infectious diseases

Acute respiratory diseases such as measles, scarlet fever, pertussis and other early symptoms of acute rhinitis may appear. In addition to the manifestations of acute rhinitis, these diseases also have the manifestations of their own diseases, and their systemic symptoms are severe, such as high fever, chills, headache, and muscle soreness. It can be identified through detailed physical examination and close observation of the course of the disease.

6. Nasal Diphtheria

Children should pay attention to identifying the disease. Nasal diphtheria has bloody snot and severe systemic symptoms, often accompanied by diphtheria.

Rhinitis complications

Acute sinusitis

Nasal inflammation spreads through the openings of the sinuses into the sinuses, causing acute suppurative sinusitis, of which maxillary sinusitis and ethmoid sinusitis are more common.

2. Acute otitis media

The infection spreads to the middle ear through the eustachian tube.

3. Acute pharyngitis, laryngitis, bronchitis, and bronchitis

The infection spreads downward through the nasopharynx. Children, the elderly, and those with low resistance can also develop pneumonia.

4. Nasal vestibitis

The infection spread directly forward.

5. Other infections

Diffusion through the nasolacrimal duct can still cause eye complications such as conjunctivitis and dacryocystitis.

Rhinitis treatment

Cause treatment

Find out the systemic and local causes, and timely treat systemic chronic diseases, sinusitis, adjacent infections, and deviated nasal septum. Improve living and working environment, exercise and improve body resistance.

Local treatment

(1) Intranasal use of glucocorticoids. Chronic rhinitis is the first choice, which has a good anti-inflammatory effect and eventually produces a decongestive effect. It can be applied for a longer period of time as required, with good efficacy and safety.

(2) Nasal cleansing For those with more or thick nasal secretions, the nasal cavity can be cleaned with normal saline to remove nasal secretions and improve nasal ventilation.

(3) Intranasal decongestants Hydroxymetazoline hydrochloride spray can be used. It should not be used continuously for more than 7 days. If you need to continue using it, you need to interrupt for 3 to 5 days. Long-term application of 0.5% to 1% ephedrine nasal drops can damage the nasal mucosa ciliary structure and should be avoided as much as possible. If you have to use it, it should be used intermittently. Dianbijing is disabled because it has been shown to cause drug-induced rhinitis.

(4) Other treatments, including closed therapy and acupuncture, have been rarely used.