Atrophic rhinitis symptoms and treatment in adults. Causes and treatment of atrophic rhinitis in adults

Probably everyone has experienced the classic runny nose. But sometimes it is not liquid that comes out of the nose, but very thick mucus. Despite the feeling of a clogged nose, it is impossible to blow your nose normally.

Atrophic rhinitis is inflammatory disease nasal mucosa, in which certain sclerotic changes occur. Most clear sign diseases: pathological drying of the nasal mucosa, the appearance of bleeding, scabs.

Causes of the disease

Exact reason atrophic rhinitis can be determined by an experienced otolaryngologist, based on the results of tests and a thorough examination of the patient. One of the pathological triggers are bacteria or fungal cultures.

Also, a dry runny nose (an alternative name for the disease) can be hereditary. In some cases, the formation of atrophic rhinitis is affected by:

• Hormonal imbalance, especially endocrine disorders that occur in the human body during puberty;
• Surgical interventions, especially surgery to change the shape of the nose, correction of the nasal septum;
• Lack of vitamin D, iron in the body.

The acute form of the disease can manifest itself after a sharp change in climate, when a high concentration of chemicals enters the nasal passages.

Varieties of the disease and classification according to ICD 10

Depending on the localization, dry runny nose can be focal and diffuse. In the focal subtype, the symptoms are less pronounced, since a small part of the septum is mainly affected (because of this, the second name of the disease: anterior dry rhinitis).

The symptoms of the diffuse subtype are more pronounced, because the disease spreads to the entire area of ​​​​the nasal passages. Also, otorhinolaryngologists sometimes use the concept of subatrophic rhinitis.

In fact, this term is not in the official international classifier of diseases. Experts only mean that the cause of the disease is insufficient nutrition of tissues. In fact, this is a subtype of rhinitis.

Both atrophic and subatrophic rhinitis can be chronic. This term is used to describe a disease state that lasts for quite a long time and can improve periodically.

In the international classifier of diseases, atrophic rhinitis does not have its own code, but refers to chronic rhinitis (J31.0). Main group: J30-J39, other diseases of the upper respiratory tract.

Is dry rhinitis the same as atrophic?

Yes, dry runny nose and atrophic rhinitis are one and the same disease. With a common cold, the nasal mucosa is hypertrophied and inflamed, there are abundant liquid discharges from the nose.

The symptoms of dry rhinitis are exactly the opposite: the sinuses become dried out, covered with crusts. Also, at the beginning of the development of the disease, the patient feels constant feeling burning in the nose.

If the disease is not fought, it will quickly develop into a chronic form (especially in children). Since it is necessary to treat dry rhinitis with the same methods and methods as atrophic, the concepts are considered synonymous.

Symptoms of the disease

Symptoms of atrophic rhinitis are quite specific, so the disease is difficult to confuse with other pathologies of the nasal cavity. In particular, a person may be concerned about the following deviations:

• A sharp clarification of the nasal mucosa;
• The appearance of dry yellow-green crusts in the nose;
• Feeling of dryness in the sinus passages;
• Violation (or complete loss) of smell;
• Isolation of blood with mucous clots.

If the pathology is ignored for a long time, an intense unpleasant odor from the nose may appear.(especially if the cause of the disease is a bacterial infection). In the most advanced cases, serious deformities of the nose can develop.

The necrotic process can spread to the membranes surrounding the brain. In most cases, atrophic rhinitis is not life-threatening, but in less than 1% of cases, the pathology ends in death.

Diagnosis of atrophic rhinitis

Even if all the signs point to the development of a dry runny nose, only a specialist should make an accurate diagnosis. The otorhinolaryngologist will determine the trigger of the disease by sampling the remnants of the dry contents of the sinuses.

In order to distinguish atrophic rhinitis from other pathologies of the nasal cavity, a CT scan or at least an x-ray of the nasal passages is usually performed.

Treatment of atrophic rhinitis begins only after the examination of blood tests by a specialist. A detailed hormonogram, as well as the absence of iron in the blood cells, will confirm or exclude the rarest causes of the disease.

How to treat atrophic rhinitis?

Modern methods of therapy can be divided into surgical and conservative. Treatment of atrophic rhinitis begins with the regular use of glycerin nasal drops, as well as washing the sinuses with a weak salt solution.

Washing.

However, such drugs will not help in any way in the fight against the reproduction of bacteria, nor will they eliminate the true source of the disease. You can treat the nose with a three percent solution of hydrogen peroxide.

The flushing procedure is quite simple: the patient should tilt his head to the side, with his mouth slightly open. Using a pipette or syringe, inject 25-50 ml of liquid into each nostril. At the same time, make sure that the solution does not get into the throat.

Tamponade.

You can also moisten a sterile cotton swab in glycerin and a two percent iodine solution, place it in one nostril and leave for two to three hours. Along with the swab, crusts will come out of the sinuses. After 2-3 procedures, it will be possible to notice the complete elimination of the unpleasant odor.

Inhalation.

fans folk treatment make inhalations from freshly picked garlic (you just need to grind a few cloves into gruel and pour a small amount of boiling water). The method can help the patient due to the very strong antibacterial properties of garlic.

Antibiotics.

If it was not possible to cure atrophy with home remedies, then antibiotic therapy is performed. Depending on the true cause of the disease, both oral and local medications can be prescribed.

However, self-administration of antibiotics is prohibited. After all, if rhinitis was provoked by a hormonal failure or beriberi, drugs will only aggravate the situation. Aggressive drugs are prescribed by an otorhinolaryngologist only after receiving the results of an analysis confirming the presence of gram-positive or gram-negative bacteria.

Operation.

Treatment of dry rhinitis can also be carried out with surgical methods. In particular, the doctor may artificially narrow the affected nostril for about 5-6 months. During this time, complete healing of the mucous membranes is observed. If atrophic rhinitis is provoked by a curvature of the nasal septum, then a corrective Plastic surgery.

Disease prevention methods

As a preventive measure, or to improve the results of conservative treatment, you can install a portable air humidifier in your apartment.

If atrophic rhinitis has already been diagnosed, then you will have to rinse your nose saline solution, as well as doing glycerin tamponade during the hottest and least humid months of the year.

You can use cotton swabs to lubricate the nostrils with sea buckthorn oil. If atrophic rhinitis has developed into chronic, then people who live in a dry climate should consider moving to a more humid area of ​​the country.

Common chronic illness, which is accompanied by the process of the onset of degenerative-sclerotic transformations in the nasal cavity, is called atrophic rhinitis - ICD code 10 J31.031.0.

In most cases, this disease is characterized by dry nasal mucosa, the appearance of crusts, the removal of which leads to the release of blood. It occurs in patients of different age categories. Most often, residents of a hot, dry climate are worried.

About the disease

Atrophic rhinitis is characterized by thinning and atrophy of the nasal mucosa. Therapy of the disease should be immediate. This is due to the fact that the membrane of the nasal mucosa and the ciliated epithelium covering it are responsible for important functions of the body.

They protect the respiratory organs from the penetration of foreign particles and from dirt. In addition, by becoming wider and narrower, the sinuses can control the amount of air that enters the lungs and regulate its temperature.

When the mucous membranes cannot fully do their job, then there are problems with the organs of the respiratory system.

The atrophic type of rhinitis is divided into two categories:

1. Primary.
2. Secondary.

This disease can be further divided into two types:

• Simple rhinitis.
• Fetid. The second name of the lake.

In the second case, an unpleasant odor appears from the discharge from the nasal cavity, as the processes of decay begin.

Causes

The causes of the appearance of the primary and secondary categories of the disease will be different.

During the primary variety, the disease develops after a special pathogen enters the nasal passages. The symptoms of this disease will be similar to the signs of simple rhinitis with infection. Therefore, a number of diagnostic measures will be needed to recognize the atrophic course.

In most cases, a presumptive diagnosis of infectious rhinitis is made. There is a scientific assumption that has no specific justification from the point of view of medicine. It states that the causative agent is Klebsiella ozenae.

The secondary variety appears after other chronic processes of atrophy in the human body. For example, according to statistical analysis, patients who suffer from atrophic gastritis are more likely to suffer from rhinitis of a similar category, in contrast to those who do not have stomach problems.

With a deficiency of vitamin D and a lack of iron in the body, the disease may appear in a secondary form.

It is worth noting that, based on the location of the disease, the chronic type of atrophic rhinitis can be of two types: focal and diffuse. The focal appearance has mild symptoms, as there is a lesion of the anterior part of the nasal septum in a small area.

With a diffuse variety, the symptoms become bright, and the disease spreads to all nasal passages.

Symptoms of atrophic rhinitis

It should be noted that the manifestation of the disease will differ according to age category. Children's symptoms of the disease are not similar to the symptoms of an adult.

Symptoms of the disease in adults

Chronic atrophic rhinitis is manifested by the presence of symptoms such as:

• Continuous sensation of dryness in the mucous membrane of the nose.
• The appearance of crusts inside the nose. These crusts bring discomfort, there is a burning sensation, as if there is a foreign object in the nose.
• Breathing through the nose is difficult.
• Smells are not always distinguishable.

When the patient tries to manually remove all the crusts, a wound or scratch appears at the site of removal. Sometimes microcracks and blood flow from the nose are formed. In some cases, these small lesions transform into ulcers, which leads to perforation of the nasal septum.

During atrophic rhinitis, the size of the lumen of the nasal passage increases, the mucous membrane becomes very thin. In some cases, the passage increases in diameter so much that the doctor will see the beginning of the Eustachian tube and the wall of the nasopharynx through it.

Chronic rhinitis does not lead to an increase in body temperature and, in general, patients feel comfortable.

The speed of progression of the disease is interconnected with how bright and acute the root causes of the appearance will be. Metaplasia can start to bother both initial stage the development of a runny nose, and after a few months.

If we are talking about lake, then the main sign of its appearance will be an unpleasant smell from the nasal passages.. The patient will not feel this aroma, but the people around him can make a remark.

In this case, there is no need for close contact, you can just be in the same room and already smell the stench. This can lead to isolation and poor social adaptation in the patient.

During an ozen in the patient's nose, you can see crusts of a brown or green hue. Illness is rare. Subatrophic fetid rhinitis has signs of a simple runny nose, differs only in smell and dry mucous membrane.

At the initial stage of the disease, the patient always wants to drink a lot, but the more he drinks, the drier the nasal membrane becomes.

Signs of the disease in children

If your child is diagnosed with a chronic runny nose, and you often treat him with drops and nasal sprays, then this may be the reason for the development of the atrophy process.

In addition, children who suffer from nasal congestion, dry mucous membranes, and regular bleeding from the nasal cavity are exposed to the disease. During the examination, the pediatrician observes anemia of the nasal mucosa and green crusts.

If not start timely treatment atrophic rhinitis, then the amount of discharge from the nose will increase, the body temperature will increase. The mucus will turn brown, and the aroma of pus will appear.

Children younger age fall into a special risk group. Since atrophic rhinitis leads to a lack of oxygen, which is caused by a breathing problem. When little air enters the body, there is a possibility of developing brain hypoxia, which is fraught with developmental delays from peers.

Diagnostics

Without a quality diagnostic examination, it is difficult to make an accurate diagnosis. This disease is considered very serious and complex, so you should not be mediocre about visits to the clinic. It is necessary to visit the ENT, which, based on your complaints, will begin the examination.

First, there is a visual examination of the nasal cavity. It is necessary to determine the level of damage to the epithelium, then the degree of spread of the pathology process is established. Since in most cases rhinitis is easily confused with other respiratory diseases, a number of other diagnostic procedures can be used:

• Radiography.
• CT scan.

The results of the studies allow concretizing the diagnosis and determining the type of sinusitis. In addition, it is possible to establish the degree of damage to bone tissue.

The doctor prescribes bakposev in order to establish the type of pathogen. This examination will give a positive result if rhinitis is provoked by an infection.

Therapy

Like any disease of the nasopharynx, atrophic rhinitis is treated in a complex manner. Use methods of conservative treatment. In acute situations, surgical intervention is required. As additional measures, the doctor may prescribe alternative therapy procedures.

Conservative treatment

Methods of conservative treatment are a priority for medical workers. In this case, a series of manipulations is prescribed, aimed at the complete elimination of the symptoms and causes of the disease.

Nose cleansing

The nasal cavity must be irrigated with saline or preparations based on sea water: Aquamaris, Dolphin, Aqualor. They do this in order to moisturize the mucous membrane and facilitate the extraction of crusts. When viscous mucus does not come out when you blow your nose, then it is eliminated using a nasal aspirator.

If there is pus, then the nasal cavity is washed with agents that have antiseptic and disinfectant properties: Furacilin, Miramistin.

To simplify the removal of crusts, oils are used: peach, vegetable, vaseline. Dip a cotton swab in the product and place it in the nasal cavity for a few minutes.

Etiotropic treatment

Atrophic rhinitis of an infectious type has a bacterial nature. To eliminate the pathological process, a course of administration is prescribed antibacterial drugs. The drug is selected based on the level of sensitivity of the isolated microbes.

Most often, drugs with a wide range of effects are selected for internal use: Amikacin, Ciprofloxacin.

During ozena, iodine-based products are used to remove fetid odors. Antibacterial ointments and inhalations are prescribed to fight the root cause of the problem.

Symptomatic treatment

In order to make mucous secretions more liquid, an alkali solution is used. They are injected into the nasal cavity or inhaled. Nasal spray mucolytics may be given.

Mucosal softening ointments and special oils reduce the process of atrophy in the nasal cavity. To make blood microcirculation better, Curantyl or Trental is prescribed.

The regeneration process will be faster if metabolism in the tissues is stimulated with Solcoseryl.

Surgical treatment

Surgical intervention is prescribed with a strong expansion of the lumen of the nasal concha or with pronounced atrophic symptoms of the nasal skeleton.

Palliative-type operations are used not to completely cure the patient, but to relieve symptoms and improve the comfort of life. Allo-, homo-, and autografts are implanted into the nasal cavity to make the lumen narrower. Sometimes the medial outer wall of the nose is displaced.

Glands are added by transplanting them from the sinus appendages.

ethnoscience

As a supplement to conservative methods, some drugs are used that are made at home. Recipes are passed down from generation to generation, received favorable reviews from satisfied patients.

1. Doctors recommend breathing over kelp powder. Use the pharmacy water of the sea or plain water, in which the salt of the Dead Sea is mixed.
2. Rosehip oil helps get rid of crusts from bad smell reduces the risk of their recurrence.
3. For the treatment of the infectious form of the disease, home drops are used. They are made from garlic and vegetable oil. You can also use onions.

Prevention measures

A number of preventive measures help reduce the risk of the onset of the disease:

• Maintain nasal hygiene.
• Personal hygiene items must be individual.
• Use oil-based drops.
• Remove crusts from the nasal cavity.
• Treat all diseases of the ear, nose and throat system in a timely manner.
• Eat vitamins.
• Monitor the humidity and temperature in your apartment.

Atrophic rhinitis may seem like a simple disease that does not require special treatment. However, untimely therapy can lead to a number of complications. Take care of your health and do not neglect going to the doctor.

Runny nose is an unpleasant pathology in adults and children that requires mandatory treatment. With absence effective therapy pathology turns into a complication in the form of atrophic rhinitis. The disease can actively progress, leading to deformation of the nasal septum and disruption of the olfactory system.

Before studying the nature of the pathology, it is desirable to analyze information regarding the disease. Atrophic rhinitis - what is it? This is a serious disease, the successful elimination of which requires knowledge of the causes of its occurrence and the distinctive features of the course. The characteristic of the pathology lies in the gradual negative change in the tissues and cells of the inner part of the nasal cavity (atrophy).

Traditional atrophic rhinitis is a disease with mixed symptomatic manifestations. The cause of the disease is environmental conditions that do not meet the standards, prolonged use of drugs against the common cold and an insufficient amount of vitamins present in the body. The development of the disease is affected by certain concomitant abnormalities: lupus, impaired functionality endocrine system and skin disease caused by thickening of the epidermis and constriction of small vessels.

Rhinitis is actively developing as a result of the use radiotherapy, the onset of menopause in women and the lack of mineral components. Additional factors that provoke the onset of the disease include:

• fracture of the bone tissue of the cranium;
• getting injured;
• making mistakes in the process of medical procedures;
• violation of the rules for conducting a cosmetic surgery.

The development of atrophic rhinitis is associated with a weakening of the activity immune system person. In case of damage to the respiratory organs in patients with childhood the cause of the active spread of the disease are infections, autoimmune processes and predisposition at the genetic level. The development of the inflammatory process is provoked by a transition that prevents nutrients from reaching the mucous membrane and enhances the inflammatory process.

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Symptoms

Chronic atrophic rhinitis, unlike other forms of pathology, has a number of features regarding symptoms. After the occurrence of an unpleasant disease at an early stage, the formation of dryness in the nose area is observed. The possibility is not excluded when the process is accompanied by a feeling of tightness. All of these signs can cause discomfort. Gradually, crusts of a dry texture appear in the nasal cavity. They are formed from the elements of the dried mucous membrane. In case of separation of the crust, nosebleeds occur. In the course of development, they intensify and continue to persist over a long period of time. Gradually, the olfactory function begins to be disturbed. The patient loses the ability to reliably sense smells, the natural process of his life activity is disturbed.

No less unpleasant symptomatic sign of atrophic rhinitis is the formation of a strong unpleasant odor in the nose. This is especially true for the pathology that has arisen as a result of exposure to a bacterial infection. With advanced forms of the disease, a deformity of the nose is detected. Pathology is able to move to the membranes that surround the brain. The form is not fatal, but in medical practice there have been cases of death of the patient.

Important! Against the background of rhinitis activity, the patient may experience a deterioration in general well-being, the onset of weakness, sleep disturbance, fast fatiguability and presence pain in the area of ​​the face. Symptoms are often confused with other pathological processes. The first signs of the pathological process can occur in childhood, the disease acquires a complicated form in adulthood.

When conducting diagnostic measures it is important to establish the exact form of the pathology. In this case, it becomes effective CT scan. The resulting image contains information regarding the form of inflammation, the nature of its distribution and the need to use surgical treatment. In the absence of the possibility of the procedure, it is recommended to give preference to radiography. It will allow you to establish the nature of the general condition of the nasal passages and sinuses.

To identify the form of the disease, a bacterial culture of the secret is carried out. At laboratory research biological material, it becomes possible to establish the causative agent of rhinitis. No less informative is the study of the condition of the skin by detecting the level of iron. Thanks to this element, the opinion regarding its role in the development of the disease is confirmed or refuted. A comprehensive study of atrophic rhinitis allows you to determine the most effective treatment that can eliminate the disease at the initial stage of development.

Treatment in adults

Therapeutic measures in adult patients involve complex treatment. At the initial stage, regular washing of the nose is recommended. For cleansing, it is necessary to use a saline solution or drugs Dolphin, Aqualor. Thanks to the action of the components, moisturizing and elimination of the formed crusts is carried out. To remove poorly drained fluid, it is recommended to use a special respirator. If pus is found in the nasal cavity, Dioxidin or Miramistin should be purchased, which have a disinfectant and antiseptic effect. To clean the crusts, any vegetable-based oil is allowed. Sea buckthorn or olive is perfect. Sterile swabs are soaked in the solution and inserted into the nasal passages.

Atrophic rhinitis is caused by exposure to bacteria, so antibiotics are prescribed to treat it. The choice of the most suitable agent is determined by the sensitivity of the microbes. Most often, a course of taking broad-spectrum drugs is carried out. To combat unpleasant odors, iodine-based products are suitable.

Therapy aimed at eliminating the manifested symptoms plays an equally important role. To remove mucus, inhalations based on alkaline solutions are used. To restore the mucosa, it is recommended to use ointments and drops with a softening effect. To normalize metabolic processes, the use of Solcoseryl ointment is prescribed. Physiotherapy treatments are considered especially effective. Activities involve the use of a helium-neon laser, electrophoresis and ultraviolet irradiation.

Important! In more advanced forms of the disease, surgery. It is necessary with a significant increase in the turbinates and a pronounced violation of the bone tissue of the nose. The procedure does not imply the elimination of the pathological process, it improves the quality of life of the patient.

Treatment in children

Treatment of atrophic rhinitis in children is carried out only after consulting an otolaryngologist. Therapy involves carrying out similar activities as in adults. Antibiotics are prescribed according to age characteristics sick and in extreme cases.

In the course of treatment, it is necessary to strictly adhere to all medical advice. The room must be well ventilated. If necessary, use a humidifier. When diagnosing a disease in a child, it is strictly forbidden to use vasoconstrictor drugs. Protect the baby from being in a dusty room. It is not recommended to clean the nose from crusts without first moistening the cavity.

How to treat folk remedies?

In the treatment of atrophic rhinitis, one should not be limited only to prescriptions. traditional medicine. They are valid only as an adjunct to the main therapy. Infusions and decoctions are widely used to strengthen the immune system and eliminate existing inflammation. The most requested options are:

1. A decoction of mint, St. John's wort and thyme. The ingredients are mixed in equal proportions. A tablespoon of the mixture is poured into a glass of hot tea and infused for half an hour. The medication should be taken three times a day after meals.
2. Chamomile decoction for washing the nasal cavity. The plant is infused under a tightly closed lid for 40 minutes. After that, the contents are filtered and cooled. May be used several times a day.
3. In order to soften and eliminate dried crusts, the use of sea buckthorn or peach oil is recommended. Enough 3 drops in each nostril. This reduces the activity of the inflammatory process. Also, for washing, the use of aloe juice is allowed.

Self-administration of therapy is excluded. All possible prescriptions are allowed to be used and treated with them only after consulting the attending physician. During the consultation, the patient needs to clarify the duration of the therapeutic course.

Measures aimed at preventing the occurrence of atrophic rhinitis imply, first of all, the observance of the rules of personal hygiene and cleanliness of the room. In addition to regular ventilation, it is recommended to install a humidifier in the room. In the hot season, it is advisable to wash the nasal cavity with a saline solution and use swabs with glycerin.

Important! When a patient is diagnosed with a disease in chronic form he is advised to move to areas with high humidity. It is important to remember about active rest, the exclusion of bad habits and maintaining healthy lifestyle life. The patient must avoid drafts or hypothermia. The patient, along with the above rules, should adhere to a balanced diet.

The atrophic form of rhinitis is a complex pathological process. The importance lies in its timely detection and selection of effective therapeutic methods. Making mistakes in treatment or slowing down actions can lead to serious and serious consequences. Disease activity negatively affects general condition patient health and well-being. Over time, there is a decrease in the working capacity and quality of human life.

Unlike other types of mucosal inflammation, atrophic rhinitis is not accompanied by an abundant release of liquid mucus or thick exudate.

Vice versa, pathological changes epithelial secretory membrane provoke its increased drying, the formation of crusts.

Tissue atrophy proceeds slowly, in several stages. A feature of the disease is the development of ozena at a late stage and a complete or partial loss of smell.

Atrophy of the nasal mucosa: what does it mean?

According to the International Classification, the thinning of the secretory epithelium is assigned the ICD-10 code - J31.0. It refers to diseases that occur in a chronic form.

which can be caused by various pathogens and negative effects on the human body:

• Viruses;
• bacteria;
• Allergens;
• Dusty air, chemicals;
• Systemic diseases;
• Prolonged exposure to cold, etc.

Inflammation of the mucous membrane gradually disrupts the work of ciliated cells and leads to its pathological disorders.

In addition, a runny nose can be triggered by the presence of systemic diseases, for example, the endocrine system. Also, taking medications or a lack of vitamins in the human body contributes to the development of respiratory dysfunctions.

The main symptoms of the disease

On examination, the ENT will notice characteristic dysfunctions of the epithelial surface - its color becomes pale pink. The structure of the cell surface is distinguished by a matte shade and a noticeable thinning of its thickness.

Chronic atrophic rhinitis is accompanied by the following manifestations:

• Increased dryness;
• The formation of dried outgrowths of the secret;
• Constant feeling of tightness;
• Periodic bleeding that stops quickly;
• Difficulty in smelling.

If the patient has, the main symptom is the fetid odor of the discharge. They are viscous, quickly form dense crusts.

The thinned secretory area is easily damaged, so patients are annoyed by bleeding. Blood does not flow profusely, it is usually found in the exudate in the form of veins.

Catarrhal secretions are viscous, viscous, have a putrid odor. The resulting dense growths cause discomfort. When they are picked, bleeding and an inflammatory process can begin.

If the functionality of the epithelium is impaired, the disease easily becomes infectious if pathogenic microorganisms penetrate the site of inflammation. Runny nose is accompanied decreased sense of smell or complete loss of smell.

If the disease is not treated correctly, dysfunctional disorders extend to the entire nasopharynx and even affect the Eustachian tubes. Over time, bones and cartilage become thinner, deformations occur that change appearance person.

Concomitant manifestations of a dysfunctional state are:

• Deterioration of general well-being;
• Weakness;
• Insomnia;
• Fast fatiguability;
• Pain in the facial area.

The first signs of atrophy appear already in childhood. A last stage can occur only after 40 years of age.

Reasons for the development of atrophic rhinitis

Basically, atrophy is provoked by the following negative effects:

hereditary factors. Often, drying and dystrophic changes in the membrane are transmitted from generation to generation. It may also be associated with other systemic diseases (malfunction of the gastrointestinal tract, endocrine system).

Upper respiratory tract infections. If intranasal inflammation, sinusitis or other pathologies caused by pathogenic microorganisms are treated incorrectly or at the wrong time, then chronic edema turns into atrophic rhinitis.

Unfavorable ecological situation. Work in hazardous enterprises where there are chemicals, dusty air or high levels of gases also have a detrimental effect on respiratory system. Even household chemicals, various cleaners with spray nozzles can cause complications.

iron deficiency. common cause the development of the disease is precisely the lack of this microelement in the body.

Studies have shown that the depletion of secretory cells is interrelated. That is, if a person has dysfunctional processes in the gastrointestinal tract, for example, with gastritis, then, most likely, in the future the same problem will affect the area of ​​​​the upper respiratory tract.

Diagnostics: basic methods

According to the symptoms and results of anterior rhinoscopy, the ENT will be able to make an accurate diagnosis. The inner anterior walls of the patient's nasal pyramid will be pale, with a dried secret, thinned.

Then the doctor during the examination will be able to assess the condition of the shell, how much the pathological changes have spread, at what stage it is currently.

In addition, it is important to check the sensitivity of the olfactory receptors. If the patient has partial or complete anosmia, then a diagnosis of dry rhinitis can be made.

In conclusion, the doctor directs the patient to radiological diagnostics: CT or X-ray of the facial part of the skull. In this case, the specialist checks whether the pathology proceeds along with sinusitis, affecting the adnexal cavities. They also determine if there are thinnings in the bones or cartilage. Source: website

The main directions in the treatment of the depleted state of the secretion zone are:

1. Stimulation of local blood circulation.
2. Supplying the body with essential nutrients.
3. Moisturizing and preventing the formation of crusts.
4. Destruction of pathogenic microflora.

Washing the nasopharynx with saline components Topical preparations that contain trace elements important for the body allow you to regulate the functional properties of the epithelial layer.

It is believed that the following elements can increase the motor activity of ciliated cilia: calcium, iron, potassium, magnesium, copper.

Salt washing is prescribed if the runny nose is allergic or vasomotor, subatrophic or infectious, since it has several healing properties:

• It has an antiseptic effect, washing out allergens, dust, infections from the cavity;
• Accelerates the healing of microcracks, damage;
• Strengthens blood vessels;
• Supplies the necessary chemicals.

You can prepare solutions from sea salt yourself or buy ready-made preparations. The frequency of manipulations and the duration of physiotherapy are selected by the ENT.

Atrophic rhinitis: drug treatment

Therapy of a pathological condition is carried out in order to eliminate the increased dryness of tissues.

It consists of a complex of various measures aimed at removing unpleasant manifestations.

To moisturize the secretory layer, prescribe products with a prolonged moisturizing effect, as well as those with a softening effect. At home, ointments are used, for example, vaseline, naphthalene, etc.

Treatment of atrophic rhinitis is also carried out with healing emollient oils:

• olive;
• sea ​​buckthorn;
• Sunflower unrefined;
• and others

Such medicines saturate tissues with moisture and, due to the presence of vitamin E, regenerate damaged areas of cells. In addition, they prevent the secretions from drying out quickly.

How to treat subatrophic rhinitis caused by a bacterial pathogen, tell the ENT. If pathogenic microorganisms are detected, antibiotics may be prescribed:

• Levomycitin;
• Tetracycline;
• Streptomycin;
• Synthomycin or others.

Most often, with atrophy, Klebsiella is detected. Therapy should be carried out within 5-7 days. Antibacterial drugs are given as intranasal drops/ointments or as injections. In parallel, during physiatry, the nose is washed with iodine medicine.

Additionally, with an antibacterial scheme for administering medications, drugs can be prescribed to increase local immunity so that the body fights pathogens on its own.

Treatment in adults

The sooner treatment is started, the sooner patients will be able to experience positive results physiatry. It is important to note that if organ depletion is provoked systemic diseases, then, first of all, adults need to seek help from narrowly specialized specialists.

Why can they send to rheumatologists a sick person with depletion of the epithelial region? This is necessary in order to for the doctor to determine if the patient has an autoimmune disorder, which often causes membrane dysfunction and a decrease in local immunity.

As already mentioned, with the infectious nature of the disease, antibiotics should be used, introducing them systemically. And in addition to the treatment regimen, irrigation with iodine solutions is prescribed.

When forming a hard-to-separate dried secret, nose drops containing oils that have a softening effect are recommended, making it easy to get dried dense exudate from the nostrils.

Washing with saline liquids or disinfectants should also be carried out.

Before the introduction of intranasal antibacterial substances, the cavity must be cleaned of secretions. You can soften the crusts with the help of turundas, which are soaked in glycerin with glucose. After their discharge, antibiotics are applied in the form of ointments or drops. Physicians also prescribe various methods physiotherapy.

If the disease proceeds for a long time and causes serious disorders that are not amenable to drug treatment then resort to surgical intervention. Operations are performed differently:

Overly wide nasal passages make procedures that narrow Airways. They can move the walls of the nose. If necessary, implants or grafts are inserted under the mucous tissues to replenish the volume of the nasal structure.

To eliminate excessive dryness, perform operations to remove the duct of the glands into the nasal cavity. Thus, it is possible to restore the necessary humidity.

In each individual case surgical methods are selected individually. But it is best to turn to the ENT even before the moment when drug therapy can no longer help the patient.

The most difficult consequence of the pathology is the spread of the debilitating process to the surrounding organs.

Treatment in children

In childhood, it is very important to recognize the cause of the development of the disease and eliminate it. First of all, do moisturizing procedures. use sea ​​salt or special preparations from a pharmacy. In addition, you should maintain normal humidity in the room.

If the child has an ailment, then antihistamines are prescribed, they make sure that he does not come into contact with allergens. Additionally, oil-alkaline inhalations are carried out to soften the crusts.

How to treat folk remedies?

Recipes from alternative medicine suggest treating intranasal wall depletion with herbal ingredients. Ingestion of various decoctions helps to increase immunity and the body's ability to fight infectious pathogens. They also have a general strengthening effect.

local use folk remedies It is aimed at moisturizing, removing the inflammatory reaction and deodorizing with crusts with an unpleasant putrefactive odor. Medicines prevent the development of increased drying of the epithelium.

Here are a few methods by which folk remedies are used:

Washing; Cleansing of the nasopharynx is carried out with therapeutic fluids (salt, saline, herbal decoctions). They relieve puffiness, moisturize, soften the growths of the dried secretion and contribute to their departure from the walls. To prepare the infusion, it is recommended to take 2 tbsp. sage and pour 0.5 liters of boiling water. After it has stood for 2 hours, it can be used for irrigation.

Another infusion recipe is made from chamomile or calendula, which have anti-inflammatory and antiseptic effects. To do this, take 1 tsp. plants and pour a glass of boiling water. Lubrication of the nostrils with oils; To moisturize tissues and soften dried growths, sea buckthorn or olive oil. They lubricate the inner walls of the nostrils well. You can also drip intranasally, 1-2 drops into each nasal passage. They contribute to the discharge of viscous secretions. Introduction turundas; Rosehip or sea buckthorn oil can be injected with cotton swabs and kept for 25-30 minutes. These medicines painlessly remove the secret, promote the healing of microcracks, relieve inflammatory processes. Moisturizing effect provides comfort during breathing.

For oral administration, you can prepare decoctions:

1. Black currant, rosehip, lingonberry and raspberry take in equal amounts and mix well. 1 tbsp mixtures are brewed in water with a volume of 200 ml. Leave to infuse for 40 minutes. Take a decoction of 70 ml three times a day. Reception is carried out after meals.
2. 1 part blackcurrant and 3 parts rose hips and nettles brewed with 400 ml water. Boil on low heat for another 10 minutes. After that, remove and insist for an hour. Take three times a day, 100 ml.

Folk remedies help to get rid of signs of dysfunctional changes.

Chronic inflammation of the nasal mucosa over time leads to the appearance of local degenerative-dystrophic changes: foci of compaction and atrophy. Patients develop atrophic rhinitis, which is manifested by the defeat of almost all structures of the nose: nerve endings, vessels, bone tissue. Pathological signs of the disease are the appearance of a purulent and thick secret, the formation of rough crusts. Over time, the nasal septum becomes thinner and deformed in patients, the sense of smell is disturbed, and short-term bleeding is possible.

Atrophic rhinitis according to the degree and prevalence of mucosal lesions is divided into limited and diffuse. IN separate group emit dangerous infection- which occupies a special place in ENT pathology. The causative agent of the disease is Klebsiella ozenae. The microorganism multiplies on the nasal mucosa and exudes an unpleasant odor that does not bother the sick at all. This is due to atrophy of the nerve centers responsible for smell.

Women suffer from this pathology much more often than men. The disease occurs mainly in adults over 30 years of age. Persons of pubertal age of the Caucasoid or Mongoloid race are prone to the development of atrophic rhinitis. Mulattos, Arabs and Negroes have never been reported with the disease.

Etiology

Atrophic rhinitis by origin is divided into 2 forms: primary and secondary. The causes of primary atrophic rhinitis have not been identified. Secondary rhinitis develops under the influence of negative environmental factors and various dysfunctions in the body.

The development of infectious atrophic rhinitis leads to the reproduction in the human body of some bacteria: bordetella, mycoplasma.

Factors contributing to the onset of the disease:

• Heredity,
• constitutional dystrophy,
• High dust and gas content in the air,
• iron deficiency in the body
• hypovitaminosis,
• unbalanced diet,
• Bad habits,
• bad climate,
• Irradiation
• production hazards,
• Abuse of vasoconstrictor drops,
• Condition after nose surgery
• Psychogenic overstrain, especially in adolescents.

Diseases leading to the development of atrophic rhinitis:

1. Gastritis, cholelithiasis, biliary dyskinesia,
2. Hormonal imbalance in the body
3. Traumatic damage to the nose and bones of the facial skeleton,
4. Immunodeficiency,
5. metabolic disorders,
6. Rhinoscleroma,
7. Specific syphilitic or tuberculosis infection,
8. Systemic lupus erythematosus, vasculitis,
9. Chronic catarrh of the upper respiratory tract.

Ozena is the extreme degree of the atrophic process. Etiological factors and the pathogenetic links of ozena have not been precisely established. There are several theories of its origin: endocrine, hereditary, trophic, metabolic, functional, psycho-neurogenic, microbial, alteration. According to the anatomical theory, ozena develops in individuals with congenital features - wide nasal passages and nasal cavity. The pathophysiological theory tells that ozena is a consequence of chronic inflammation in the nose, which occurs in severe form. The bacterial theory is confirmed by the presence of clinical material of Klebsiella ozena in the culture. Neurogenic theory: the cause of ozena is a dysfunction of the autonomic nervous system. Endocrine theory: ozena develops in women during menstruation, pregnancy and menopause.

Ozena is characterized by thinning of the mucosa, a decrease in the size and number of cells, damage to nerve fibers and glandular structures. The ciliated epithelium transforms into a squamous blood vessels become thinner and inflamed, the bone tissue is replaced by fibrous tissue. The nose is deformed: it becomes saddle-shaped or resembles a duck in shape. The respiratory organ ceases to function normally and be a reliable defender of the whole organism from pathogenic microbes penetrating from the outside.

Symptoms

The clinic of atrophic rhinitis develops gradually. First, patients develop a frequently aggravated bacterial infection. The inflammation is catarrhal in nature. Gradually, the mucous secretions are replaced by purulent ones, an infectious inflammation of the nasal mucosa develops, which is accompanied by thickening of the secretion and formation. Blood supply and nutrition of the nasal mucosa are disturbed, dystrophy progresses.

• Simple atrophic rhinitis manifested by dryness of the mucosa, a tendency to form crusts, lack of appetite, insomnia, the appearance of mouth breathing and whistling sounds on inspiration, impaired sense of smell. Discharge from the nose becomes scanty, viscous, sometimes nosebleeds occur. Patients feel that there is a foreign body in the nose.
• Subatrophic rhinitis- a special kind of disease in which the nutrition of the nasal mucosa is disturbed, it begins to dry and become covered with crusts. Morphological and Clinical signs pathologies are expressed insignificantly. Some experts consider this form an independent disease, while others consider it as one of the stages of atrophic rhinitis.
• Symptoms of infectious atrophic rhinitis are catarrhal phenomena: sneezing, runny nose, conjunctivitis, subfebrile or heat body. Patients become restless, nervous, sleep poorly at night and eat little. Over time, asymmetry of both sides of the jaw occurs, the nasal septum softens and curves. The face becomes puffy, swelling appears under the eyes.
• In patients suffering from ozena, the nasal cavity is enlarged, the mucous membrane is thinned, pale and dry. In the nose, mucus with a sharp unpleasant odor is produced and quickly dries up. Purulent discharge, filling the nasal passages, forms rough yellowish-greenish crusts. The atrophic process from the nasal mucosa often descends to the pharynx, larynx and trachea, which is manifested by hoarseness and a painful cough. The patient emits a fetid odor. As a result of damage to the receptors of the olfactory analyzer, anosmia develops. Due to atrophy of the nerves in the nose, the sensitivity of the mucous membrane is disturbed, and patients do not feel the flow of inhaled air. It seems to them that the nose is blocked, although the nasal cavity is empty. Patients do not feel the bad smell emanating from them. The special reaction of others leads children to a depressed state, and drives adults into depression.

Complications of the disease:

1. Anosmia,
2. Decreased local immunity,
3. Inflammation of the trachea, larynx and pharynx,
4. nose deformity,
5. Inflammation of the paranasal sinuses,
6. Inflammation of the eyeball
7. Ear infection,
8. trigeminal neuralgia,
9. Pathology of the gastrointestinal tract: dyspepsia, gastritis,
10. Depression, apathy, neurasthenia.

Diagnostics

Diagnosis of the disease begins with listening to the patient's complaints and a general examination. The presence of fetid crusts and anosmia allows the specialist to suspect this ailment.

Then the nasal cavity is examined - rhinoscopy is performed, during which a pale pink, dry and matte mucous membrane is detected. Easily vulnerable blood vessels are visible through it. In the nasal cavity there are crusts of yellow-green color. The nasal passages are dilated and the conchas are reduced. The posterior wall of the nasopharynx is easy to see during rhinoscopy.

atrophic rhinitis

The discharge of the mucous membrane of the nose and throat is sent to bacteriological examination to the microbiological laboratory. In the process of studying the microflora of the nasal cavity, bacteriologists usually detect a monoculture - ozenous Klebsiella or an association of microorganisms.

To confirm the proposed diagnosis and exclude concomitant sinusitis, patients are referred for tomographic or radiographic examination of the paranasal sinuses.

Treatment

Conservative therapy:

• Nose cleansing. The nasal cavity is irrigated with saline or medicines Aquamaris, Aqualore, Dolphin. This is necessary to moisturize the mucosa and remove crusts. If thick discharge badly depart when otsmarkivanie, they are removed using a nasal aspirator. In the presence of purulent contents in the nose, it should be washed with a disinfectant or antiseptic solution - Furacilin, Dioxidin, Miramistin. Anyone will help clear the nose from crusts vegetable oil- sea buckthorn, eucalyptus, olive, peach. Cotton swabs are soaked in oil and injected into the nose.

Correctly selected conservative therapy allows you to improve the condition of the mucous membrane, accelerate regeneration processes, restore the secretion of glandular structures.

Surgery carried out with a significant expansion of the turbinates and severe atrophy of the bone skeleton of the nose. Palliative surgery is not intended to cure the patient, but to make life easier. During surgical intervention patients are implanted with allo-, homo- and autografts in the nasal cavity to narrow its size or move the medial outer wall of the nose. Patients are added to the mucous membrane of the gland by transplantation from the paranasal sinuses.

conservative therapy atrophic rhinitis is supplemented with traditional medicine.

Prevention

Preventive measures to avoid the development of pathology: