Vasomotor rhinitis - causes, symptoms, diagnosis and treatment
Vasomotor rhinitis - A chronic disease of the mucous membrane of the nasal cavity that occurs in violation of autonomic and endocrine regulation of vascular tone. Various non-specific stimuli, hormonal imbalance in the body alter the reactivity of the mucosa and lead to the appearance of paroxysmal sneezing, rhinorrhea, and nasal breathing difficulty. Diagnosis is carried out otolaryngologist physician based on clinical examination, anterior rhinoscopy, laboratory and instrumental studies. Treatment involves administering antihistamines, agents influencing the vascular tonus, surgery.
Vasomotor rhinitis
Rhinitis - hyperreactivity of the nasal mucosa in violation of the general and local vascular tone. The disease moves quickly into a chronic form, and appears suddenly arising attacks of sneezing, runny nose and difficulty breathing through the nose in response to the receipt in the upper respiratory tract of non-specific physical and chemical stimuli.
Disease occurs most often in people aged 20-40 years, accounting for 25% of all cases of chronic rhinitis (just sick of about 600 million people worldwide rhinitis of different etiology). According to statistics, in the United States about 20 million people, and in Western Europe - about 50 million people suffering from non-allergic rhinitis. Timely appeal to the ENT doctor and the right treatment of vasomotor rhinitis can prevent the onset of complications (hypertrophic rhinitis, nasal polyps, chronic sinusitis), and to restore the broken social adaptation.
hypertension, vascular dystonia), acute and chronic stress conditions, neurotic disorders.
Provoking factor can become viral and bacterial infection of the upper respiratory tract, adenoids in children with a deviated septum and other defects that impede the normal flow of air through the nasal cavity or compressing blood vessels located in the submucosal layer of the inferior turbinates.
Prolonged and indiscriminate use of vasoconstrictor nose drops often leads to disruption of the vascular tone and the appearance of rhinitis. The same can be said about some of the systemic effects of drugs Drugs - Antihypertensive drugs (beta-blockers, reserpine, ACE inhibitors), neuroleptics (chlorpromazine), oral contraceptives.
In men aged 50-55 and older occurs reflex form vasomotor rhinitis in response to the consumption of certain foods and especially of alcohol (beer, wine, whiskey), causing dilation of blood vessels in the nasal cavity and swelling of the mucous membrane in violation of nasal breathing. Often identify specific factors provoking occurrence of the disease, you can not. In this case we speak of idiopathic rhinitis.
insomnia, headaches and other symptoms of distress on the part of the nervous system.
Depending on the frequency of exacerbations distinguish intermittent (attacks occur no more than 3-4 days a week) and persistent (exacerbations occur almost daily) rhinitis. The disease is considered to be easy, if the local symptoms are moderate, there is no change in the general state of health and moderate or severe - in the presence of sleep disorders, decreased ability to work and activity during the day, as well as frequent prolonged paroxysms of vasomotor rhinitis.
otolaryngologist, laboratory and instrumental examinations that allow to rule out other oral mucosal diseases of the nose with similar symptoms.
Already in the collection of medical history can reveal features that distinguish from allergic vasomotor rhinitis (development in adults, seasonality is not characteristic of the disease, the lack of genetic predisposition and allergic reactions on the skin, as well as bronchopulmonary system). Often patients vasomotor rhinitis note that for a long time used vasoconstrictor nose drops.
During the front rhinoscopy in patients with vasomotor rhinitis revealed the severity of swelling of nasal mucosa in acute, in the presence of mucosal white or bluish spots, which may also occur in other places - at the rear ends of the nasal cavities, pharynx and larynx (in case of pharingo- and laryngoscopy).
Radiography of the paranasal sinuses does not reveal any changes, except for the wall swelling of the mucous membrane of maxillary sinuses in acute and polyps that may occur in the sinuses with hypertrophic process. Laboratory tests of blood samples and allergological usually within the normal range (allergic rhinitis detected eosinophilia, elevated Ig E, positive skin tests). According to testimony at the vasomotor rhinitis can be performed endoscopic examination of the nasal cavity, rinopnevmometriya and other studies.
In a study of pregnant women with vasomotor rhinitis study the hormonal status (serum levels of estriol, estradiol, progesterone) and determined the initial vegetative tone women (usually prevails the parasympathetic division of the autonomic nervous system). Differential diagnosis of vasomotor rhinitis is conducted with allergic and nonallergic rhinitis, sinusitis, tuberculosis, syphilis, scleroma, Wegener's granulomatosis.
sinusitis, tonsillitis, polyps), normalize the function of the autonomic nervous system, adjust the intake of drugs, giving up drugs that can disrupt vascular tone and worsen the disease.
From the conservative methods of treatment practiced appointment system antihistamines (loratadine, fexofenadine, desloratadine, ebastine, cetirizine), antiallergic agents for topical application in the form of drops, sprays (mometasone, dimethindene). Used physiotherapy (intranasal electrophoresis with calcium, diphenhydramine, thiamine, inhalation using a nebulizer), acupuncture.
Used holding endovasal blockades with novocaine to inferior turbinates, the introduction of sclerosing agents and local cauterization of the nasal mucosa by various chemical agents. If vasomotor rhinitis notes marked edema of the lower nasal turbinate and constant nasal congestion, used intranasal corticosteroids (beclomethasone and budesonide).
In the absence of effect of conservative measures in vasomotor rhinitis successful surgical treatment. Depending on the particular clinical picture of the disease, the general condition of the patient can be used submucosa vasotomy inferior turbinates, ultrasound or microwave disintegration of the inferior turbinates, and their laser or radiowave destruction. In some cases, surgery is necessary to perform again. The ineffectiveness of the above methods of surgical intervention is an indication for sparing lower turbinotomy. Often, surgery on the nasal turbinates combined with performing septoplasty, adenotomy, endoscopic correction of intranasal structures.
With timely treatment to the doctor, otolaryngologist, and the appointment of individually chosen and the most effective in this particular case a method of treating vasomotor rhinitis prognosis is favorable.