Effective treatment of atrophic rhinitis in adults. Symptoms and treatment of atrophic rhinitis

Atrophy of the nasal mucosa is a phenomenon in which not only the structure is disrupted, but also the function of the nerve endings and mucous membrane is disrupted. In this case, not only the person’s sense of smell suffers, but also the physiological filtration of air, its warming, and the removal of pathogenic bacteria.

What needs to be done?

If such a disease occurs, it is absolutely necessary to immediately contact an ENT doctor, who will examine the nasopharyngeal mucosa visually and with the help of special instruments,, if necessary, prescribe additional studies, and prescribe the necessary treatment for atrophy of the nasal mucosa in this case.

Since the disease is accompanied by the formation of a crust of pus, under no circumstances should it be torn off. This causes additional trauma to the already damaged mucous membrane.

Conservative methods of treating pathology involve the use of antibacterial agents, which are often administered parenterally (intravenously) or intramuscularly. As a rule, these are broad-spectrum antibiotics (3rd and 4th generation cephalosporins or fluoroquinolones), which should be selected by the doctor individually for each patient, taking into account the degree of the disease and individual intolerance to the drug. Ideally, such treatment should be used only after bacterial culture for sensitivity has been performed and the result has been obtained.

Sometimes topical antibacterial agents are administered topically. Cleaning the nasal cavity from purulent crust occurs using special alkaline solutions.

Treatment necessarily consists of constant sanitation and rinsing of the nasal cavity, as well as the use of reparative and healing agents. For hygiene of the nasal cavity in such cases, saline or soda solutions are suitable, as well as furatsilin, potassium permanganate, hydrogen peroxide (3%), iodine-containing products without ethyl. You can add a few drops of celandine or aloe when washing. Irrigation with saline solution is also used.

The use of some physiotherapy techniques gives good results. For example, there is significant improvement after iontopheresis and diathermy. Some doctors recommend that such patients purchase an air ionizer for home use.

It is acceptable to use oil drops - sea buckthorn, rosehip, peach or olive; you can also soak tampons with them and put them in your nose. In case of such pathology, it is appropriate to inhale with tea tree oil. Alkaline or oil inhalations are also used on the recommendation of a doctor.

Rinsing the nose with sea water is very effective. It has antiseptic properties, helps get rid of pathogenic microflora and pollution, relieves inflammation and improves local recovery processes. During sanatorium-resort treatment, it is useful to rinse the nose with mineral waters of local sources.

Suppression of proteolytic microorganisms is achieved by applying a solution of glucose with glycerol to the mucosa. The lack of some elements is compensated for with iron and vitamin D preparations. To improve the general condition, it is recommended to take multivitamin complexes.

To achieve positive results, treatment should be carried out in courses over two months, three times a year.

Surgical techniques are also used. The most famous and popular for atrophy of this kind is Jung's method. It consists of artificially narrowing the nasal cavity and is used in severely advanced cases.

It is completely unacceptable to use vasoconstrictors in the form of drops in the treatment of atrophy of the nasal mucosa!

Complete relief from atrophy does not occur, but with adequate treatment the process can be stopped and the patient’s condition can be maintained at a satisfactory level. Sometimes there are cases that the initial stages of this disease occurred during pregnancy or after childbirth.

How does atrophy of the nasal mucosa manifest?

Despite the fact that descriptions of a disease similar to atrophy of the nasal mucosa have been found since ancient times, the true mechanism of its development has not yet been studied in detail. There are suggestions that neurovegetative, neuroendocrine and other types of disorders that are under the control of the hypothalamic-pituitary department of the central nervous system are involved.

Symptoms of atrophy in the nasal mucosa appear as follows:

Green or yellow crusts appear, mucopurulent in nature, which are difficult to remove;
There is a foul smell from the nose, which the patient himself does not feel;
Loss of smell occurs; with complete atrophy, anosmia becomes irreversible.
The passages of the nose expand as destruction of the nasal concha or perforation of the nasal septum occurs;
The cartilage and bones that form the nasal cavity are destroyed;
The addition of other diseases - eustachitis, tubo-otitis, laryngitis, etc.
Manifestation of the picture of atrophic rhinitis during rhinoscopy.

People suffering from this pathology experience dryness, burning or itching in the nose, and too free passage of air through it. They are more likely than others to suffer from inflammatory pulmonary diseases, since the natural barrier is disrupted and pathogenic microflora passes directly into the bronchi.

What are the causes of atrophy of the nasal mucosa?

There are many factors that can lead to the development of a disease such as atrophy of the nasal mucosa:

Hereditary predisposition. If close family members have had atrophic diseases of the nose, then their relatives are also highly likely to develop the same thing.
Race. It was reliably noted that representatives of the Mongoloid and Caucasian races are more prone to atrophy of the nasal mucosa.
Hormonal imbalances. Often observed during puberty and in women during menopause.
Consequences of radiation therapy or surgery with removal of the nasal concha.
Autoimmune diseases.
Chronic or acute infections of the nasopharynx.
Bad habits (tobacco smoking, drug addiction).
Deficiency of certain substances - lack of iron or vitamin D.
Chronic allergic rhinitis.
Complicated acute viral infection.
Abuse of vasoconstrictor drops.

An advanced stage of the disease can lead to the development of complete atrophy of the nasopharynx, which often ends with the addition of chronic diseases of neighboring organs and disruption of their functions.

Atrophic rhinitis is a chronic pathology of the nasal mucosa, which is characterized by degenerative sclerotic changes (dryness and thinning of the nasal mucosa, atrophy of the bone tissue of the organ, damage to blood vessels and nerve endings).

The consequence of atrophic changes is loss of smell, deformation of the nasal septum, scanty but frequent nosebleeds. The disease is diagnosed in representatives of absolutely all age categories.

Residents of environmentally unfavorable regions, as well as areas with prevailing dry and hot weather, are most susceptible to it.

What is it?

Atrophic rhinitis is an inflammation of the walls of the nasopharynx, which can be caused by various pathogens and negative effects on the human body:

Viruses;
Bacteria;
Allergens;
Dusty air, chemicals;
Systemic diseases;
Long stay in the cold, etc.

Inflammation of the mucous membrane gradually disrupts the functioning of ciliated cells and leads to its pathological disorders. In addition, a runny nose can be caused by the presence of systemic diseases, for example, the endocrine system. Also, taking medications or lack of vitamins in the human body contributes to the development of respiratory tract dysfunction.

Reasons for the development of the atrophic form

Basically, atrophy is provoked by the following negative influences:

Hereditary factors. Often, drying out and degenerative changes in the shell are passed on from generation to generation. This 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 runny nose.
Unfavorable environmental conditions. Working in hazardous enterprises where there are chemicals, dusty air or high levels of gases also has a detrimental effect on the respiratory system. Even household chemicals and various cleaners with spray nozzles can cause complications.
Iron deficiency. A frequent cause of the development of the disease is precisely the lack of this microelement in the body.

Research has 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 upper respiratory tract.

First signs

Simple AR is characterized by the following symptoms:

reduction of mucus discharge;
tendency to form crusts, but odorless;
difficulty breathing through the nose;
feeling of dryness in the nose;
decreased sense of smell;
slight nosebleeds;
irritability, general weakness.

Ozena is characterized by a sharp atrophy of the mucous membrane and bone walls of the nasal cavity. Rough crusts with a very unpleasant odor quickly form on the walls. After they are removed, the foul odor disappears for a while until new crusts form. At the same time, the patient himself does not feel this smell due to atrophy of the receptor zone of the olfactory analyzer.

Symptoms in adults

Symptoms of atrophic rhinitis in adults appear gradually. First, patients develop a frequently exacerbating bacterial rhinitis. The inflammation is catarrhal in nature. Gradually, mucous discharge is replaced by purulent, infectious inflammation of the nasal mucosa develops, which is accompanied by thickening of the secretion and the formation of crusts. The blood supply and nutrition of the nasal mucosa are disrupted, and dystrophy progresses.

Simple atrophic rhinitis is manifested by dry mucous membranes, a tendency to form crusts, lack of appetite, insomnia, the appearance of mouth breathing and whistling sounds when inhaling, and impaired sense of smell. Discharge from the nose becomes scanty, viscous, and sometimes nosebleeds occur. Patients experience a feeling that there is a foreign body in the nose.
Subatrophic rhinitis is a special type of disease in which the nutrition of the nasal mucosa is disrupted, it begins to dry out and crust over. Morphological and clinical signs of pathology are slightly expressed. Some experts consider this form to be 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, low-grade or high body temperature. Patients become restless, nervous, sleep poorly at night and eat little. Over time, asymmetry occurs on both sides of the jaw, the nasal septum softens and becomes bent. The face becomes puffy, swelling appears under the eyes.
In patients suffering from ozena, the nasal cavity is dilated, the mucous membrane is thinned, pale and dry. Mucus with a pungent unpleasant odor is produced in the nose and quickly dries. 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. A foul odor emanates from the patient. 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 impaired, and patients do not feel the flow of inhaled air. It seems to them that the nose is stuffy, although the nasal cavity is empty. Patients do not feel the bad odor coming from them. The special reaction of others leads children to a depressed state, and drives adults into depression.

The following general symptoms may be the reason for an unscheduled consultation with an otolaryngologist:

dryness of the mucous membrane of the olfactory organ;
difficulty breathing through the nose;
abnormal formation of crusts in the organ cavity;
a feeling of tightness in the nose that is constant;
periodic, scanty nosebleeds that are easy to stop;
itching, burning in the nose.

These general symptoms are necessarily accompanied by poor appetite, sleep disturbances, nervousness, and headaches.

How to distinguish a regular runny nose from an atrophic one?

A common runny nose is an inflammatory process of the nasal mucosa. It can occur for various reasons: the impact of pathogenic microorganisms, allergens, and other factors that provoke the disease. A common runny nose is characterized by an acute course with a gradual increase in symptoms. But provided that the patient has a strong immune system or uses the correct treatment regimen, the disease goes away within 10-14 days.

A common runny nose is characterized by 3 stages of development:

During the first 2-48 hours, the patient experiences severe itching and burning in the nasal passages, slight hyperthermia is noted, the sense of smell deteriorates, the perception of tastes is impaired, and nasal breathing becomes difficult.
With the active development of the virus in the body, abundant discharge of liquid mucus is observed from the nose, nasal breathing is complicated, the ears become blocked, body temperature rises, appetite disappears, lacrimation and frequent sneezing are possible.
After 4-5 days, the secreted mucus becomes thicker and has a purulent consistency. From about the 7th day, the nasal passages begin to clear of viruses, the mucous discharge gradually disappears, and the patient’s condition improves.

With atrophic rhinitis, the dryness of the mucous membrane is permanent, there is practically no mucous discharge, but nasal congestion persists. Due to the crusts that form in the nose, there is a feeling of the presence of a foreign body, and minor bleeding is possible.

Diagnosis by a specialist

The diagnosis is made on the basis of complaints, medical history, results of laboratory and instrumental research methods. Patients with AR report painful nasal dryness, sticky, crusty discharge, and difficulty breathing.

On examination, pallor of the skin and visible mucous membranes and mouth breathing are observed. With AR, pale, atrophic mucous membranes are determined during rhinoscopy.

During anterior rhinoscopy, the following signs are revealed:

expansion of the nasal cavity, which is associated with a decrease in the inferior turbinates;
the mucous membrane is pale pink, thin, shiny;
dilated nasal passages are filled with thick, purulent secretion;
The discharge dries and forms crusts on the walls of the nasal cavity.

Atrophy of the mucous membrane and turbinates leads to the fact that during anterior rhinoscopy the posterior wall of the nasopharynx is freely visualized. The disorder can spread not only to the nasal cavity, but also to the pharynx, larynx and trachea.

Bacteriological culture during ozenosis reveals ozenous Klebsiella.

Cytological or histological examination of the nasal mucosa during ozena reveals:

sharp thinning of the mucous membrane;
thinning of the bone tissue of the turbinates and walls of the nose;
metaplasia of columnar epithelium into stratified squamous epithelium;
reduction in the number of mucous glands;
poor development or disappearance of cavernous tissue;
changes in blood vessels such as obliterating endarteritis;
replacement of bone tissue of conchae with connective tissue.

Additionally, a clinical blood test is performed, iron levels are determined, and radiography or computed tomography of the paranasal sinuses is prescribed.

How to treat atrophic rhinitis?

If atrophic rhinitis occurs, self-medication is highly undesirable, since over the time spent on it, most likely to no avail, the pathology will progress. In treatment, in addition to traditional medications, physiotherapy, traditional methods, and in severe cases, surgery are used.

At home, treatment is carried out only after visiting a doctor and agreeing with him on methods, which may include folk remedies. Such therapy is excluded when there are already complications affecting the lungs, brain, or all systems and organs combined.

Hospitalization of a patient who does not have complications is required only if he has a high risk of developing them, or there are indications for surgical therapy.

The method of therapy is chosen exclusively by the attending physician, depending on the general condition of the patient and the stage of atrophic rhinitis.

Drug treatment

Treatment of primary and chronic (secondary) forms of atrophic rhinitis is complex. It includes several areas of therapeutic interventions:

Etiotropic therapy is treatment that is aimed at eliminating the cause of the pathological process. Since in most cases, one of the causes of mucosal atrophy is its infection, antibacterial agents with a wide spectrum of activity are prescribed. Which ones exactly depend on the type of pathogen that is identified as a result of bacteriological research. As a rule, the doctor prescribes Amikacin, Rifampicin or Ciprofloxacin.
Pathogenetic therapy - measures that are necessary to improve the functional state of the nasal mucosa, for which moisturizers Aqualor, Dolphin, Aquamaris are used. These preparations include sea water, which makes it possible to carry out effective hydration. It is available in the form of drops or aerosol. It is important to monitor sufficient air humidity at home (you can increase it with the help of modern household humidifiers). If there is purulent content in the nasal passages, antiseptic solutions are used - these are Furacilin Dioxidin and Miramistin. To improve blood circulation, use Trental and Pentoxifylline ointments. To activate the healing processes of atrophic changes - Solcoseryl.
Symptomatic therapy is aimed at improving breathing and thinning mucus, for which combined drugs are used for the treatment of atrophic rhinitis, for example mucolytics - Rinofluimucil and Sinuforte. Moisturizing the nasal passages to prevent the formation of dry crusts is done with Vaseline and Camphor ointment.

Conservative treatment of atrophic rhinitis in adults and children is carried out in long courses that improve the condition. And during the period of remission, general recommendations are followed aimed at preventing exacerbations, and the key point here will be moisturizing procedures.

Physiotherapy

Physiotherapy is indicated to improve blood circulation in mucosal tissues and reduce its atrophy. The main procedures are:

electrophoresis;
helium-neon laser;
ultraviolet irradiation;
inductothermy of the nasal cavity;
aeroionotherapy.

Physiotherapy treatment is carried out according to strict medical recommendations.

Surgical treatment

If conservative methods fail to improve the condition of the nasal mucosa, surgical intervention is considered. The operation is prescribed when there is a pronounced expansion of the nasal passages and the spread of the atrophic process to bone and cartilaginous structures. Surgical intervention is performed for palliative purposes, since it is impossible to completely cure a person from the disease. The operation is performed to alleviate the patient's condition and improve the quality of life.

During the operation, allo-, auto-, and homografts are implanted into the nasal cavities to reduce their lumen. Sometimes movement of the medial wall of the nose is indicated. Glands are removed from the paranasal sinuses in order to transplant them into the mucous membrane of the nasal cavities. This makes it possible to moisturize the mucous membrane and cleanse it of contamination by moving the secretion with the help of cilia in the direction of the nostrils.

Treatment of ozena

Ozena takes a long time to treat. Patients have been under clinical care for many years. Only if the disease is detected at the first stage, a short course of antibacterial therapy is sufficient for recovery.

When ozena is carried out:

General therapy. Antibiotics are prescribed (streptomycin, gentamicin, monomycin, cephalosporin). It is irrational to use these drugs orally. Antibiotics are administered locally via inhalation.
General pathogenetic therapy. Medicines that enhance immunity and vitamins are prescribed. For intense headaches - analgesics. Given that the disease is associated with social difficulties, patients need unobtrusive positive psychotherapy.
Local therapy. Several times a day, the nasal cavity is cleared of mucus and drying crusts. Oils are used to soften them. Then they are removed, and the mucous membrane is lubricated with an antiseptic.
Physiotherapy. It is carried out to moisturize the drying out mucous membrane, improve blood circulation and trophism.
Surgical treatment. Necessary for palliative improvement of nasal breathing. The nasal cavity is narrowed using the implantation of various materials. This helps, but only in that the mucous membrane dries out less. Surgery is recommended for advanced atrophic rhinitis and ineffective conservative treatment.

Folk remedies for treatment

Traditional medicine also helps fight atrophic rhinitis. Effective recipes:

Infusion based on raspberry leaves, black currants, lingonberries and rose hips: 1 tbsp. l. Pour a glass of boiling water over the ingredient mixture and let it brew for 40 minutes. Divide into 3 parts and apply within 24 hours after meals.
A decoction of rose hips, nettle leaves and black currants. 1 tbsp. l. ingredients (ratio 3/3/1) pour 2 glasses of water, boil for 10 minutes. Let cool and set for 60 minutes. Take the drug 0.5 cups three times a day.
Anti-inflammatory agent. Thyme herb, valerian roots, St. John's wort and mint are mixed in proportions of 1/1/2/2, crushed and added to tea. Drink 0.5 cups three times a day after meals.
Cleaning solution. To prepare it you need 2 tsp. herbs, 2 cups boiling water. Let it brew for 2 hours.
Infusion for washing and relieving inflammation. 1 tsp. Brew chamomile flowers (calendula) with a glass of boiling water.
Softening agents. Painless removal of nasal crusts is possible by instilling olive/sea buckthorn oil, which effectively eliminates purulent discharge and has an antiseptic effect.

The following techniques help fight ozena (fetid atrophic rhinitis):

Dry seaweed is ground into powder form. Inhale the resulting mixture three times a day for 2 weeks.
Regular instillation of a few drops of rosehip oil into the nose eliminates foul odor and crusty formations.
Anti-infective agent for 4 times daily instillation. Grind 2 cloves of garlic, mix with 1 tbsp. l. vegetable oil, heat for 30 minutes in a water bath. Strain and apply 2 drops.
Regenerating agent. Prepared with aloe vera. 1 tbsp. l. juice, brew 0.5 cups of boiling water. Use the resulting broth for rinsing once a day.

As a rule, complete relief from the disease is guaranteed only after taking antibiotics. Traditional recipes are not able to have such a strong effect on the body, so it is better to use them as an additional measure.

Complications

If the disease is ignored, the following complications may arise:

anosmia - loss of sense of smell;
decreased immunity;
deformation of the nose, inflammation of the paranasal sinuses;
pharyngitis, laryngitis;
ear inflammation;
meningitis;
pneumonia;
tracheobronchitis;
inflammation of the eyeballs;
purulent sinusitis, ethmoiditis, sphenoiditis, frontal sinusitis;
inflammation of the pharynx, larynx, trachea;
gastrointestinal pathologies;
trigeminal neuralgia;
depressive states, neurasthenia, apathy.

Prevention

To prevent an aggravation of the runny nose, you should avoid hypothermia, do not sit in a draft, try to ventilate the room, but only in the absence of the patient.

The best preventative measure is a healthy lifestyle and moderate hardening of the body. In the mornings you need to do light gymnastics, and in the evenings you need to run at the stadium or walk in the park. At the same time, it is recommended to monitor your own diet, increasing the amount of fresh vegetables and fruits in your diet, excluding alcohol, fatty and spicy foods.

Atrophy of the nasal mucosa is a chronic disease in which pathological changes and degradation of the tissue lining the nasal cavity are observed. In this case, the shell ceases to normally perform the tasks assigned to it. Atrophy of the nasal mucosa is accompanied by the death of nerve endings in the nasal cavity. In the final stages of the disease and in especially severe cases, bone and cartilage tissue are affected.

The result of such processes is the expansion of the nasal passages, as well as an increase in the lumen of the nasal cavity. If you do not seek professional help in a timely manner, serious complications arise in the form of a weakened sense of smell (hyposmia) or its complete loss (anosmia).

Key reasons and factors

It should be noted that descriptions of this disease are found quite often in ancient sources. This means that people have suffered from atrophy of the nasopharyngeal mucosa since time immemorial. Unfortunately, scientists still have not been able to understand the mechanism by which this pathology occurs. There are a number of theories that the onset of the pathological process is related to neuroendocrine, neurovegetative and some other disruptions that fall under the responsibility of the hypothalamic-pituitary department of the central nervous system.

It is possible to cure mucosal atrophy, but before doing so, it is advisable to establish the exact cause that led to the appearance of such a disease. According to doctors, the following factors may contribute to the development of such pathological changes:

Hereditary predisposition (genetic factor) is one of the key causes of mucosal atrophy. In other words, this disease can be transmitted at the genetic level. And not just directly, but even bypassing several generations. In some cases, a similar disease is diagnosed in distant relatives.
Often the pathological process is activated at the time of puberty, when the hormonal background is not highly stable. Typically, atrophy appears in young girls.
Quite often, atrophy is provoked by prolonged rhinitis (inflammation of the mucous membrane), as well as recurrent rhinitis. They are caused by viral factors or autoimmune viral diseases.
A common factor that causes the atrophic process is hormonal disorders in the body.
In rare cases, the pathological mechanism is triggered by a lack of minerals and vitamins (for example, vitamin, iron, and so on).
Belonging to the Caucasian and Mongoloid races. It has been scientifically proven that atrophic processes in the mucous membrane are most often diagnosed in people belonging to the above-mentioned races.
The cause of the pathology can be radiation therapy.
Another risk factor is surgical operations aimed at removing the nasal concha.
Diabetes mellitus can also cause this disease.
Smoking and substance abuse contribute to the appearance of such a disease.

Excessively frequent use of medicinal drops to narrow blood vessels also negatively affects the condition of the nasal mucosa.

Symptoms

What are the symptoms of atrophy? Manifestations of the disease are as follows:

Dry mouth that does not go away, but intensifies after quenching thirst.
The functioning of the nasopharynx is disrupted, so in some cases the patient may find that it becomes more difficult for him to breathe.
Due to the degradation of the tissues lining the nasopharynx, an unpleasant odor appears.
The nasal cavity becomes covered with pustules. Later they dry out and become crusty. It is quite difficult to remove them yourself; you cannot do without professional help and a special cleaning solution.
The destruction of the nasal concha is accompanied by expansion of the respiratory passages.
Microbes attack cartilage and bone tissue. Therefore, the nasal bones noticeably decrease in size.
In severely advanced forms of atrophy, the general symptoms include others that are characteristic of diseases of nearby organs (larynx, pharynx, and so on).

Treatment

However, such a terrible disease at first glance can be easily cured. However, only subject to the correct choice of therapy, which can only be done by a qualified specialist. Today, this disease is treated mainly by two methods - surgical and conservative.

Conservative treatment involves the use of physiological and isotonic medical solutions (Lugol's solution, silver nitrate, etc.). With their help, the mucous membrane is lubricated and dried purulent growths are removed. After this, special softening and healing ointments are used. Often the rehabilitation course is supplemented by taking antibiotics (their type is determined individually for each patient) and physiotherapeutic procedures:

ultraviolet irradiation;
laser therapy;
electrophoresis (exposure to tissue with weak currents) and others.

In the absence of positive results of conservative treatment, the possibilities of modern surgery are used. The main goal of the operation is to artificially reduce the size of the nasal passages. For this, two main methods are used - installing implants and moving the nasal walls. To decide on one option or another, doctors take into account the symptoms, individual characteristics of the patient and previous therapy (if any, of course, took place).

During the treatment process, you should not try to remove dried pustules on your own. This is dangerous and can cause serious complications. This procedure is performed exclusively by the attending physician using solutions based on menthol oil.

Diagnostics and prevention

To get rid of atrophy, it is necessary to promptly localize the source of the disease - the place where bacteria accumulate. They contribute to the destruction of cartilage and bone tissue. The first stage of diagnosis is a consultation with an otolaryngologist (ENT). He examines the patient and develops an optimal rehabilitation course based on the tests.

To prevent the occurrence of such a disease, we recommend constantly paying attention to the condition of the mucous membrane and maintaining its hygiene. This is the main condition for a healthy nasopharynx. Rinse your nose daily, then lubricate the mucous membrane with special ointments for restoration and healing. If you have a runny nose, do not overuse drops to constrict blood vessels. This is one of the most powerful factors that triggers the mechanism of degradation of nasal tissues.

At the first signs of atrophic processes, consult a doctor immediately. The sooner treatment begins, the less painful and more successful it will be. Regularly walk in the fresh air, do breathing exercises and physical exercises, eat right - all this will help make your body stronger and more resilient. This way, you will eliminate the risk of nasopharyngeal pathologies.

Unlike other types of inflammation of the mucous membrane, atrophic rhinitis is not accompanied by copious secretion of liquid mucus or thick exudate.

On the contrary, pathological changes in the epithelial secretory membrane provoke its increased drying out and the formation of crusts.

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

Atrophy of the nasal mucosa: what does it mean?

According to the International Classification, 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;
Long stay in the cold, etc.

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

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

Main symptoms of the disease

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

Chronic atrophic rhinitis is accompanied by the following manifestations:

Increased dryness;
Formation of dried secretion growths;
Constant feeling of tightness;
Intermittent bleeding that stops quickly;
Difficulty smelling.

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

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

Catarrhal discharge is viscous, viscous, and has a putrid odor. The resulting dense growths cause discomfort. When they are picked, bleeding and inflammation may begin.

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

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

Associated manifestations of a dysfunctional state are:

Deterioration in general health;
Weakness;
Insomnia;
Fatigue;
Painful sensations in the facial area.

The first signs of atrophy appear already in childhood. And the 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 influences:

Hereditary factors. Often, drying out and degenerative changes in the shell are passed on from generation to generation. This 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 runny nose.

Unfavorable environmental conditions. Working in hazardous enterprises where there are chemicals, dusty air or high levels of gases also has a detrimental effect on the respiratory system. Even household chemicals and various cleaners with spray nozzles can cause complications.

Iron deficiency. A frequent cause of the development of the disease is precisely the lack of this microelement in the body.

Research has 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 upper respiratory tract.

Diagnostics: basic methods

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

Then, during the examination, the doctor will be able to assess the condition of the membrane, how far the pathological changes have spread, and what stage it is at the moment.

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 refers the patient to radiological diagnostics: CT scan or x-ray of the facial part of the skull. In this case, the specialist checks whether the pathology occurs along with sinusitis, affecting the accessory cavities. They also determine whether there is any thinning in the bones or cartilage. Source: website

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

Stimulation of local blood circulation.
Supplying the organ with essential nutrients.
Moisturizes and prevents crust formation.
Destruction of pathogenic microflora.

Rinsing the nasopharynx with saline components Topical preparations that contain microelements 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 rinsing is prescribed if the runny nose is allergic or vasomotor, subatrophic or infectious, since it has several healing properties:

Has an antiseptic effect, washing out allergens, dust, and infections from the cavity;
Accelerates the healing of microcracks and damage;
Strengthens blood vessels;
Supplies the necessary chemical elements.

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 specialist.

Atrophic rhinitis: treatment with medications

Therapy for the pathological condition is carried out to eliminate increased tissue dryness.

It consists of a set of various measures aimed at relieving unpleasant manifestations.

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

Atrophic rhinitis is also treated with healing emollient oils:

Olive;
Sea buckthorn;
Unrefined sunflower;
and others

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

An ENT specialist will tell you how to treat subatrophic rhinitis caused by a bacterial pathogen. If pathogenic microorganisms are identified, antibiotics may be prescribed:

Levomycytin;
Tetracycline;
Streptomycin;
Syntomycin or others.

Most often, Klebsiella is detected during atrophy. Therapy should be carried out for 5-7 days. Antibacterial medications are prescribed in the form of intranasal drops/ointments or in the form of injections. At the same time, during physiatry, the nose is rinsed with iodine medicine.

Additionally, with an antibacterial regimen of medication administration, drugs may be prescribed to increase local immunity so that the body can independently fight pathogens.

Treatment in adults

The sooner therapy is started, the sooner patients can experience the positive results of physiatry. It is important to note that if organ depletion is caused by systemic diseases, then first of all adults need to seek help from highly specialized specialists.

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

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

When a dried secretion that is difficult to separate is formed, nasal drops containing oils that have a softening effect are recommended, making it easy to remove the dried dense exudate from the nostrils.

You should also wash with saline liquids or disinfectants.

Before administering intranasal antibacterial substances, be sure to clear the cavity of secretions. You can soften the crusts using turundas, which are soaked in glycerin and glucose. After they leave, antibiotics are applied in the form of ointments or drops. Doctors also prescribe various physical therapy methods.

If the disease lasts a long time and causes serious disorders that cannot be treated with medication, then surgical intervention is resorted to. Operations are performed in different ways:

With excessively wide nasal passages They do procedures that narrow the airways. They can move the walls of the nose. If necessary, implants or grafts are inserted under the mucous tissue to fill the volume of the nasal structure.

To relieve excessive dryness, perform operations to remove gland ducts 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 contact an ENT specialist before drug therapy can no longer help the patient.

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

Treatment in children

In childhood, it is very important to recognize the cause of the disease and eliminate it. First of all, moisturizing procedures are done. Use sea salt or special preparations from the pharmacy. In addition, normal air humidity in the room should be maintained.

If a child has an illness, then antihistamines are prescribed and care is taken to ensure that he does not come into contact with allergens. Additionally, oil-alkaline inhalations are performed to soften the crusts.

In children, the elimination of a pathological condition should be carried out by an experienced ENT specialist, who at an early stage of the disease will be able to eliminate unpleasant symptoms and prevent the occurrence of more severe consequences.

How to treat with folk remedies?

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

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

Here are a few methods used to treat with folk remedies:

Washing; Cleansing of the nasopharynx is carried out with medicinal liquids (saline, saline, herbal decoctions). They relieve swelling, moisturize, soften the growths of dried secretions and promote their removal 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 you need to take 1 tsp. plants and pour a glass of boiling water. Lubricating the nostrils with oils; Sea buckthorn or olive oil is used to moisturize tissues and soften dried growths. They lubricate the inner walls of the nostrils well. You can also drop 1-2 drops intranasally into each nasal passage. They promote the discharge of viscous secretions. Introduction of turunda; Rosehip or sea buckthorn oil can be injected with cotton swabs and kept for 25-30 minutes. These medications painlessly remove secretions, promote the healing of microcracks, and relieve inflammation. The moisturizing effect provides comfort while breathing.

For oral administration, you can prepare decoctions:

Black currants, rose hips, lingonberries and raspberries take in equal quantities and mix well. 1 tbsp. The mixture is brewed in 200 ml of water. Leave to brew for 40 minutes. Take a decoction of 70 ml three times a day. Take after meals.
1 part black currant and 3 parts each rosehip and nettle Brew with 400 ml water. Boil over low heat for another 10 minutes. After this, remove and leave for an hour. Take 100 ml three times a day.

Folk remedies are good at helping to get rid of signs of dysfunctional changes.

Chronic atrophic rhinitis is divided into primary (genuine), the etiology and pathogenesis of which are not entirely clear, and secondary, caused by exposure to external harmful factors of the working environment (chemical, dust, temperature, radiation, etc.) and unfavorable climatic conditions.

ICD-10 code

J31.0 Chronic rhinitis

Causes of chronic atrophic rhinitis

In the occurrence of chronic atrophic rhinitis, infections of the upper respiratory tract, nasal trauma, and previous hyperplastic and catarrhal processes in the nasal cavity play a certain role. If with secondary chronic atrophic rhinitis, which develops under the influence of harmful industrial conditions, it is possible to trace all stages of this process - from catarrh of the nasal mucosa to dystrophy, characterized by its atrophy, then with primary chronic atrophic rhinitis, the causes of the disease largely remain unidentified. As for the pathogenesis, there are several “theories”: infectious (chronic inflammatory processes of the rhinosinus system), alterative (exposure to dry hot air, industrial dust particles, ionizing studies, consequences of radical surgical interventions on endonasal structures, nasal injuries).

According to V.I. Voyachek (1953), B.S. Preobrazhensky (1966), G.Z. Piskunov (2002) and other domestic rhinologists, primary chronic atrophic rhinitis refers to local manifestations of a systemic dystrophic process, in which the atrophic process is subjected to the mucous membrane of not only the upper respiratory tract, but also the internal organs. In connection with this situation, B.S. Preobrazhensky considered it more correct to call chronic atrophic rhinitis rhinopathia chronica atrophica. V.I. Voyachek believed that the extreme manifestation of chronic atrophic rhinitis is ozena. Many authors (especially foreign ones) do not distinguish chronic atrophic rhinitis as an independent clinical form, but believe that hypotrophy of the nasal mucosa is only a symptom or consequence of more general diseases of the upper respiratory tract and the whole body, and associate this disease with metabolic disorders, chronic infections, ozena, damage to the vegetative part of the nasal mucosa resulting from viral, coccal and other infections. It is also impossible to exclude the factor of a general constitutional (genetic) predisposition to dystrophies of the mucous membrane of the body, the trigger of which can be both external harmful factors and endogenous primary diseases, such as rhinoscleroma, syphilis, etc.

There is also an opinion that simple atrophic rhinitis in some cases and under certain conditions is the initial stage of ozena.

Pathological physiology and pathological anatomy of chronic atrophic rhinitis. Atrophy in general, as a pathological process, is characterized by a decrease in volume and size, as well as qualitative changes in cells, tissues and organs expressed to varying degrees, and usually develops during various diseases, differing in this from hypoplasia (hypogenesis), i.e. underdevelopment of tissue, an organ, part of the body or an entire organism that is based on a violation of embryogenesis (the extreme expression of hypoplasia is aplasia, or agenesis, the absence of an entire organ or part of the body). Chronic atrophic rhinitis refers to pathological atrophies that differ from physiological ones (for example, senile atrophy of SpO, retina, olfactory nerve, etc.) by the presence of a contributing pathological process and certain qualitative features. Depending on the cause of occurrence, several forms of atrophy are distinguished: trophoneurotic, hormonal, metabolic, functional and from the influence of harmful external physical, chemical and mechanical factors. Probably, in the etiology and pathogenesis of chronic atrophic rhinitis, as well as in chronic atrophic processes in other ENT organs, most of the specified processes and factors that cause them are involved to one degree or another.

Pathological changes in the nasal mucosa are manifested by a decrease in the volume and quantity of all its elements, including the glandular apparatus, autonomic and sensory nerve fibers, including receptors of the olfactory organ. Cilia disappear, the cylindrical ciliated epithelium metaplasizes into squamous epithelium, blood and lymphatic vessels become thinner and lose elasticity, and in advanced cases, the bone tissue of the rhinosinus system also undergoes atrophy.

Symptoms of chronic atrophic rhinitis

The main symptoms are a feeling of dryness in the nose, the presence of viscous, difficult to blow out discharge that dries into a yellowish-grayish crust, a decrease in the sense of smell to its complete absence. With anterior rhinoscopy, the nasal mucosa looks pale, dry, with easily vulnerable vessels visible through it; the nasal turbinates are reduced, the common and individual nasal passages are wide to such an extent that the posterior wall of the nasopharynx becomes visible. One of the types of chronic atrophic rhinitis is anterior dry rhinitis.

The clinical course of chronic atrophic rhinitis is long (years and decades), depending on the effectiveness of the complex treatment used.

Treatment of chronic atrophic rhinitis

Patients suffering from chronic atrophic rhinitis usually turn to an ENT specialist when the atrophic process has reached a pronounced stage, often incurable, therefore in such cases the treatment takes quite a long time and with minimal effect, bringing relief to the patient only for the period of use of certain drugs. The effectiveness of treatment increases if the cause of the atrophic (dystrophic) process is found and eliminated, for example, one or another occupational hazard, bad habits, chronic source of infection, etc.).

Treatment is divided into general, local medicinal and surgical.

General treatment of chronic atrophic rhinitis

General treatment includes vitamin therapy, the use of general stimulating drugs (aloe extract in injections; aloe juice, aloe tablets, aloe with iron, phytin, rutin, calcium glucoiate - per os, etc.). Agents that improve microcirculation and angioprotectors are also used to improve the trophism of the nasal mucosa (xanthine nicotinate, pentoxifylline, agapurine, etc.). As a result of a number of studies, it was found that many patients suffering from degenerative processes in the mucous membrane of the upper respiratory tract and gastrointestinal tract have a disorder of iron metabolism. When this fact is established, patients with atrophic rhinitis are prescribed iron preparations - aloe extract with iron, ferrum Lek, various iron salts (monocomponent and with vitamins). In some cases, if there are appropriate general therapeutic indications, agents that activate tissue metabolism are prescribed for systemic use (inosine, orotic acid, trimetazidine, cytochrome C, etc.). To improve microcirculation in the nasal mucosa, it is advisable, along with the above-mentioned drugs, to prescribe appropriate angioprotectors that improve the flow of nutrients and medications into the atrophic nasal mucosa (dipyridamole, calcium dobesylate, xanthinol nicotinate, pentoxifylline preparations). General treatment includes climatic and balneotherapy, walks in a coniferous forest, etc. General treatment with these means must be carried out after a thorough laboratory examination and in agreement with the therapist and other specialists.

Local treatment of chronic atrophic rhinitis

Against the background of general treatment, local treatment is carried out, which is aimed at activating metabolic processes in the nasal mucosa, regenerating it into columnar epithelium, goblet cells, glandular apparatus, capillaries, lymphatic vessels, interstitial tissue and VNS neurofibrils. However, achieving such a complex effect on the nasal mucosa is possible only with careful selection of drugs for local application and installation use (solutions, ointments, gels). For this purpose, in the last century, various forms of preparations of iodine, ichthyol, phenol, silver, and even diachilon patch were recommended. The basis of this dosage form is the finest lead oxide powder (10 parts), which is mixed with pork fat (10 parts), olive or sunflower oil (10 parts) and water (Gebra ointment). The drug was proposed by the founder of the Austrian dermatological school F. Gebra (1816-1880) for the external treatment of a number of skin diseases as a protective and covering agent. Some of these drugs have not lost their importance today, but not all of them have a positive effect. Thus, preparations of iodine, silver, and lead, while exerting a beneficial effect at the initial stages of treatment, with prolonged use aggravate the atrophic process in the nasal mucosa. More effective, which do not have an inhibitory effect on the nasal mucosa with long-term use, are herbal preparations containing many vitamins and biologically active substances (sea buckthorn oil, rosehip oil, carotoline, thuja oil, eucalyptus, etc.). Promising for the treatment of atrophic rhinitis, especially in the presence of trophic ulcerations in the area of the nasal septum, ointment and gel forms of the drug solcoseryl containing a standard deproteinized extract from the blood of calves with high activity of the retculoendothelial system. Solcoseryl contains factors that help improve metabolism in tissues and accelerate regeneration processes (solcoseryl gel, solcoseryl ointment).

riboflavin 0.1 g, glucose 0.3 g, sodium salt of CMC 2.9 g, distilled water 94 ml;
1% solution of sodium adenosine triphosphate 50 ml, sodium salt of CMC 3 g, distilled water 47 ml;
1% solution of humisol 97 ml, sodium salt CMC 3 g.

Complex treatment with these composite forms, according to these authors, leads to an improvement in the condition of the mucous membrane, regeneration of its epithelium, and revitalization of the secretory function of the mucous glands.

Before using active drugs, it is necessary to clear the nasal cavity of dry crusts and viscous mucus. For this purpose, solutions and ointments of proteolytic enzymes are used for rinsing the nasal cavity and for application.