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 disturbed, but also the function of the nerve endings and the mucous membrane is disturbed. At the same time, not only the sense of smell suffers in a person, 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 visually and with the help of special tools the nasopharyngeal mucosa, if necessary, prescribe additional studies, and prescribe the treatment of atrophy of the nasal mucosa necessary in this case.

Since the disease is accompanied by the formation of a crust of pus, in no case should it be torn off. This causes additional trauma to the already damaged mucosa.

Conservative methods of treating pathology consist in 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 the doctor should select individually for each patient, taking into account the degree of the disease and individual intolerance to the drug. Ideally, this treatment should be applied only after susceptibility cultures have been performed and results are obtained.

Sometimes topical antibacterial agents are administered topically. Cleaning the nasal cavity from a purulent crust occurs with the help of special alkaline solutions.

Treatment necessarily consists in constant sanitation and washing of the nasal cavity, as well as the use of reparative and healing agents. For the 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 is also used.

Good results are obtained by the use of some methods of physiotherapy. For example, there is a significant improvement after ionopheresis 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 lay them in the nose. It is appropriate for such a pathology to do inhalations with tea tree oil. Alkaline or oil inhalations are also used on the recommendation of a doctor.

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

The suppression of proteolytic microorganisms is achieved by applying a solution of glucose with glycerin to the mucous membrane. The lack of some elements is replenished 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 for two months, three times a year.

Surgical techniques are also used. The most famous and popular for atrophy of this kind is the Young method. It consists in the artificial narrowing of the nasal cavity and is used in severely neglected cases.

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

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

How is atrophy of the nasal mucosa manifested?

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

Symptoms of atrophy in the area of the nasal mucosa are manifested as follows:

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

People suffering from such a pathology feel dryness, burning or itching in the nose, too free passage of air through it. They are more likely than others to suffer from inflammatory lung diseases, as the natural barrier is broken, and the 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 can also develop the same with a high degree of probability.
Racial affiliation. It was reliably noted that representatives of the Mongoloid and Caucasoid races are more prone to atrophy of the nasal mucosa.
Hormonal imbalances. Often observed during puberty and in women during menopause.
The consequences of radiation therapy or surgery with the removal of the nasal concha.
Autoimmune diseases.
Chronic or acute infections of the nasopharynx.
Bad habits (smoking, drug addiction).
Deficiency of certain substances - lack of iron or vitamin D.
Chronic allergic rhinitis.
Complicated acute viral infection.
Abuse of vasoconstrictor drops.

A far 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 a violation of their functions.

Atrophic rhinitis is a pathology of the nasal mucosa of a chronic course, 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, nerve endings).

The consequence of atrophic changes are loss of smell, deformity of the nasal septum, scanty, but frequent bleeding from the nose. The disease is diagnosed in representatives of absolutely all age categories.

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

What it is?

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;
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.

Reasons for the development of the atrophic form

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 the respiratory system. Even household chemicals, 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 trace element 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 upper respiratory tract.

First signs

Simple AR is characterized by the following features:

reduction of separated mucus;
tendency to form crusts, but odorless;
difficult nasal breathing;
feeling of dryness in the nose;
decreased sense of smell;
minor nosebleeds;
irritability, general weakness.

Ozena is characterized by a sharp atrophy of the mucous membrane and bone walls of the nasal cavity. Coarse crusts with a very unpleasant odor quickly form on the walls. After their removal, the fetid 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 aggravated bacterial rhinitis. The inflammation is catarrhal in nature. Gradually, mucous secretions are replaced by purulent ones, an infectious inflammation of the nasal mucosa develops, which is accompanied by thickening of the secretion and the formation of crusts. Blood supply and nutrition of the nasal mucosa are disturbed, dystrophy progresses.

Simple atrophic rhinitis is manifested by dryness of the mucosa, a tendency to crusting, lack of appetite, insomnia, the appearance of mouth breathing and whistling sounds on inspiration, and 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 is 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 of pathology are expressed slightly. 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, low-grade or high body temperature. 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.

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

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 constriction in the nose, which is permanent;
occasional scanty nosebleeds that are easy to stop;
itching, burning in the nose.

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

How to distinguish a common cold from atrophic?

The common cold is an inflammation of the nasal mucosa. It can occur for various reasons: this is the impact of pathogenic microorganisms, and allergens, and other factors that provoke the disease. The common cold is characterized by an acute course with a gradual increase in symptoms. But provided that the patient has strong immunity or uses the correct therapy regimen, the disease disappears within 10-14 days.

The common cold is characterized by 3 stages of development:

During the first 2-48 hours, the patient feels severe itching and burning in the nasal passages, there is a slight hyperthermia, the sense of smell worsens, the perception of tastes is disturbed, nasal breathing becomes difficult.
With the active development of the virus in the body, an abundant discharge of liquid mucus is observed from the nose, nasal breathing is complicated, the ears are “laid”, the body temperature rises, appetite disappears, lacrimation and frequent sneezing are possible.
After 4-5 days, the secreted mucus becomes thicker, has a purulent consistency. From about the 7th day, the nasal passages begin to be cleared of viruses, the mucous discharge gradually disappears, 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. Because of the crusts that form in the nose, there is a feeling of the presence of a foreign body, minor bleeding is possible.

Diagnosis by a specialist

The diagnosis is made on the basis of complaints, anamnesis data, results of laboratory and instrumental research methods. Patients with AR report excruciating dryness in the nose, viscous discharge with crusting, and difficulty breathing.

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

With ozen, during the anterior rhinoscopy, the following signs are revealed:

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

Atrophy of the mucous membrane and shells leads to the fact that with anterior rhinoscopy, the posterior wall of the nasopharynx is freely visualized. Violation can extend not only to the nasal cavity, but also to the pharynx, larynx and trachea.

Bacteriological culture during lake reveals ozenous Klebsiella.

Cytological or histological examination of the nasal mucosa in ozen reveals:

sharp thinning of the mucous membrane;
thinning of the bone tissue of the shells and walls of the nose;
metaplasia of the columnar epithelium into stratified squamous;
decrease in the number of mucous glands;
weak development or disappearance of cavernous tissue;
changes in the vessels by the type of obliterating endarteritis;
replacement of the bone tissue of the shells with connective tissue.

Additionally, a clinical blood test is performed, the level of iron is determined, and an x-ray or computed tomography of the paranasal sinuses is also prescribed.

How to treat atrophic rhinitis?

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

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

Hospitalization of a patient without 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 the atrophic rhinitis.

Medical treatment

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

Etiotropic therapy is a 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 infectious lesion, antibacterial agents of a wide spectrum of activity are prescribed. Which ones - depends on the type of pathogen, which is established 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 moisturizing agents Aqualor, Dolphin, Aquamaris are used. These preparations include sea water, which makes it possible to carry out effective moisturizing. It is available in the form of drops or an aerosol. It is important to monitor sufficient air humidity at home (you can increase it with the help of modern household humidifiers). In the presence of purulent contents in the nasal passages, antiseptic solutions are used - this is Furacilin Dioxidin, and Miramistin. To improve blood circulation, ointments Trental and Pentoxifylline are used. To activate the healing processes of atrophic changes - Solcoseryl.
Symptomatic therapy - is aimed at improving breathing, thinning mucus, for which combined drugs are used to treat atrophic rhinitis, for example, mucolytics - Rinofluimucil and Sinuforte. Humidification of the nasal passages, to prevent the formation of dry crusts, is carried out with Vaseline and Camphor ointment.

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

Physiotherapy

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

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

Treatment with the use of physiotherapy is carried out according to strict medical recommendations.

Surgery

If conservative methods could not improve the condition of the nasal mucosa, the question of surgical intervention is considered. The operation is prescribed for a pronounced expansion of the nasal passages and the spread of the atrophic process to the bone, cartilage structures. Surgery is performed with a palliative purpose, since it is impossible to completely cure a person of the disease. The operation is performed to alleviate the patient's condition and improve the quality of life.

During the operation, allo-, auto-, homotransplants are implanted into the nasal cavities to reduce their lumen. Sometimes the movement of the medial wall of the nose is shown. Glands are removed from the paranasal sinuses in order to transplant them into the mucous membrane of the nasal cavities. This allows you to provide moisturizing of the mucosa, cleansing it from pollution by moving the secret with the help of cilia in the direction of the nostrils.

Ozena treatment

Ozen is treated for a long time. Patients have been in the dispensary for many years. Only if the disease was detected at the first stage, a short course of antibiotic therapy is sufficient for recovery.

When the lake is carried out:

general therapy. Prescribe antibiotics (streptomycin, gentamicin, monomycin, cephalosporin). It is irrational to use these drugs orally. Antibiotics are administered topically by inhalation.
General pathogenetic therapy. Prescribe medications that enhance immunity, vitamins. With intense headache - 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 cleaned of mucus, drying crusts. Oils are used to soften them. Then they are removed, and the mucosa is smeared with an antiseptic.
Physiotherapy. It is carried out to moisturize the drying mucous membrane, improve blood circulation and trophism.
Surgery. It is necessary for the palliative improvement of nasal breathing. The nasal cavity is narrowed by implantation of various materials. This helps, but only in that the mucous membrane dries out less. The operation is recommended for advanced atrophic rhinitis, ineffectiveness of conservative treatment.

Folk remedies for treatment

Traditional medicine also helps to fight atrophic rhinitis. Effective Recipes:

Infusion based on raspberry leaves, blackcurrant, cranberries and rose hips: 1 tbsp. l. pour a glass of boiling water over the ingredient mixture, let it brew for 40 minutes. Divide into 3 parts, apply within a day after a meal.
A decoction of rose hips, nettle leaves and black currant. 1 st. l. ingredients (ratio 3/3/1) pour 2 cups of water, boil for 10 minutes. Let cool and steep for 60 minutes. Take the drug 0.5 cup three times a day.
Anti-inflammatory agent. Thyme grass, valerian roots, St. John's wort and mint are mixed in proportions of 1/1/2/2, crushed and added to tea. Drink three times a day after meals for 0.5 cups.
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 chamomile flowers (calendula) brew a glass of boiling water.
softening agents. Painless removal of nasal crusts is possible with the instillation of olive / sea buckthorn oil, which effectively eliminates purulent discharge and has an antiseptic effect.

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

Dry seaweed is crushed to a 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 fetid odor and crust formations.
Anti-infective agent for 4-fold 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. Made with aloe. 1 st. l. juice brew 0.5 cups of boiling water. The resulting decoction is used for washing once a day.

As a rule, complete elimination of the disease is guaranteed only after taking antibiotics. Folk 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 occur:

anosmia - loss of smell;
decreased immunity;
deformation of the nose, inflammation of its paranasal sinuses;
lake-bearing pharyngitis, laryngitis;
ear infection;
meningitis;
pneumonia;
tracheobronchitis;
inflammation of the eyeballs;
purulent sinusitis, ethmoiditis, sphenoiditis, frontal sinusitis;
inflammation of the pharynx, larynx, trachea;
pathology of the gastrointestinal tract;
trigeminal neuralgia;
depression, neurasthenia, apathy.

Prevention

In order to prevent the aggravation of the common cold, one should avoid hypothermia, do not sit in a draft, try to ventilate the premises, but only in the absence of the patient.

The best preventive measure is a healthy lifestyle and moderate hardening of the body. In the morning you need to do light gymnastics, and in the evenings run in 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 the diet, excluding alcohol, fatty and spicy foods.

Atrophy of the nasal mucosa is a chronic disease in which there is a pathological change and degradation of the tissue lining the nasal cavity. 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. At the final stages of the disease and in especially severe cases, bone and cartilage tissue is 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 weakening of the sense of smell (hyposmia) or its complete loss (anosmia).

Key Causes and Factors

It should be noted that the description of this disease is found all the time in ancient sources. This means that people have suffered from atrophy of the nasopharyngeal mucosa since time immemorial. Unfortunately, scientists have not yet been able to understand the mechanism of the appearance of such a pathology. There are a number of theories that neuroendocrine, neurovegetative and some other failures, which are the responsibility of the hypothalamic-pituitary department of the central nervous system, are related to the beginning of the pathological process.

It is possible to cure mucosal atrophy, but before that it is advisable to establish the exact cause that led to the appearance of such a disease. According to doctors, the following factors can 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 bypassing even 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. Usually atrophy appears in young girls.
Quite often, atrophy is provoked by prolonged rhinitis (mucosal inflammation), as well as recurrent rhinitis. They are caused by viral factors or autoimmune viral diseases.
A common factor that causes an atrophic process is hormonal disorders in the body.
In rare cases, the pathological mechanism triggers a lack of minerals and vitamins (for example, vitamin, iron, and so on).
Belonging to the Caucasoid 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 races.
Radiation therapy can be the cause of the pathology.
Another risk factor is surgery to remove the nasal concha.
Diabetes can also cause this disease.
Smoking and substance abuse contribute to the appearance of such an ailment.

Excessive use of medicinal drops for vasoconstriction also negatively affects the condition of the nasal mucosa.

Symptoms

What are the symptoms of atrophy? The manifestations of the disease are:

Dry mouth, which does not go away, but increases after thirst is quenched.
The work of the nasopharynx is disturbed, therefore, in some cases, the patient may find that it has become harder for him to breathe.
Due to the degradation of the tissues lining the nasopharynx, an unpleasant odor appears.
The nasal cavity is covered with pustules. In the future, they dry out and become covered with a crust. Removing them on your own is quite difficult, here you can not do without professional help and a special cleaning solution.
The destruction of the nasal concha is accompanied by the expansion of the respiratory passages.
Microbes attack cartilage and bone tissue. Therefore, the nasal bones are noticeably reduced in size.
With severely neglected forms of atrophy, others are connected to the general symptoms, which 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 under the condition of the correct choice of therapy, which can only be done by a qualified specialist. Today, such a 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, and so on). With their help, the mucous membrane is lubricated and dried purulent growths are removed. After that, special softening and healing ointments are applied. Often, the rehabilitation course is supplemented by taking antibiotics (their type is determined individually for each patient) and physiotherapy procedures:

ultraviolet irradiation;
laser therapy;
electrophoresis (impact on tissues with weak currents) and others.

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

In the process of treatment, you should not try to remove dried pustular formations on your own. This is dangerous - it 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 localize the focus of the disease in a timely manner - 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.

In order to prevent the occurrence of such an ailment, we recommend that you constantly pay attention to the condition of the mucosa and carry out its hygiene. This is the main condition for a healthy nasopharynx. Rinse the nose daily, then lubricate the mucous membrane with special ointments for recovery and healing. With a runny nose, do not abuse drops to narrow blood vessels. This is one of the most powerful factors that triggers the mechanism of nasal tissue degradation.

At the first signs of atrophic processes, consult a doctor immediately. The sooner treatment begins, the less painful and more successful it will be. Walking regularly in the fresh air, doing breathing exercises and physical exercises, eating right - all this will help make the body stronger and more resilient. Thus, you eliminate the risks of the appearance of pathologies of the nasopharynx.

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

On the contrary, pathological changes in the 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 the appearance of a 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. And the last stage can occur only after the age of 40.

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 the respiratory system. Even household chemicals, 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 trace element 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:

Stimulation of local blood circulation.
Supplying the body with essential nutrients.
Moisturizing and preventing the formation of crusts.
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 therapy is started, the sooner patients will be able to experience the positive results of physiatry. It is important to note that if organ depletion is provoked by 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. Doctors also prescribe various methods of physiotherapy.

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

Overly wide nasal passages doing procedures that narrow the 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 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.

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

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.

The local use of folk remedies 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; 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 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 drugs painlessly remove the secret, promote the healing of microcracks, and relieve inflammation. Moisturizing effect provides comfort during breathing.

For oral administration, you can prepare decoctions:

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.
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 atrophic rhinitis is divided into primary (genuine), the etiology and pathogenesis of which are not entirely clear, and secondary, due to the influence of external harmful factors of the production environment (chemical, dust, temperature, radiation, etc.) and adverse 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, previous hyperplastic and catarrhal processes in the nasal cavity play a certain role. If in secondary chronic atrophic rhinitis, which develops under the influence of harmful working conditions, all stages of this process can be traced - from catarrh of the nasal mucosa to dystrophy, characterized by its atrophy, then in primary chronic atrophic rhinitis, the causes of the disease remain largely unidentified. As for pathogenesis, there are several of its “theories”: infectious (chronic inflammatory processes of the rhinosinus system), alteration (exposure to dry hot air, industrial dust particles, ionizing study, the 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 mucous membrane of not only the upper respiratory tract, but also the internal organs. In connection with this provision, B.S. Preobrazhensky considered it more correct to call chronic atrophic rhinitis rhinopathia chronica atrophica. VI Voyachek believed that ozena is the extreme manifestation of chronic atrophic rhinitis. Many authors (especially foreign ones) do not single out chronic atrophic rhinitis as an independent clinical form, but consider that hypotrophy of the nasal mucosa is only a symptom or consequence of more general diseases of the upper respiratory tract and the whole organism, and associate this disease with metabolic disorders, chronic infections, ozena, a lesion of the vegetative link 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 as a whole as a pathological process is characterized by a decrease in volume and size, as well as qualitative changes in cells, tissues and organs that are expressed to varying degrees, and usually develops during various diseases, differing from hypoplasia (hypogenesis), i.e. tissue underdevelopment, organ, part of the body or the whole organism, which is based on a violation of embryogenesis (the extreme expression of hypoplasia is aplasia, or agenesis, the absence of a whole organ or body part). 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 exposure to 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 indicated processes and factors that cause them are involved to one degree or another.

Pathological and anatomical 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 olfactory organ receptors. The cilia disappear, the cylindrical ciliated epithelium metaplases into a squamous epithelium, the blood and lymphatic vessels become thinner and lose their 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 a viscous, hard-to-speak discharge that dries into yellowish-grayish crusts, and a decrease in the sense of smell to its complete absence. With anterior rhinoscopy, the nasal mucosa looks pale, dry, with easily vulnerable vessels translucent through it; the nasal conchas 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 varieties 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 a rather long time and with minimal effect, bringing relief to the patient only for the period of using 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, a chronic focus of infection, etc.).

Treatment is divided into general, local medical and surgical.

General treatment of chronic atrophic rhinitis

General treatment includes vitamin therapy, the use of general stimulant drugs (aloe extract in injections; aloe juice, aloe tablets, aloe with iron, phytin, rutin, calcium glucoate - per os, etc.). They also use agents that improve microcirculation and angioprotectors to improve the trophism of the nasal mucosa (xanthinol nicotinate, pentoxifylline, agapurine, etc.). As a result of a number of studies, it was found that many patients suffering from dystrophic processes in the mucous membrane of the upper respiratory tract and gastrointestinal tract have a violation 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 drugs, to prescribe appropriate angioprotectors that improve the flow of nutrients and medications into the atrophic nasal mucosa (dipyridamole, calcium dobesilate, xanthinol nicotinate, pentoxifylline preparations). General treatment includes climate and balneotherapy, walks in coniferous forests, 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 a cylindrical epithelium, goblet cells, glandular apparatus, capillaries, lymphatic vessels, interstitial tissue and ANS neurofibrils. However, the achievement of such a complex effect on the nasal mucosa is possible only with careful selection of preparations for local application and installation use (solutions, ointments, gels). For this, in the last century, various forms of preparations of iodine, ichthyol, phenol, silver, and even a diachilon patch were recommended. The basis of this dosage form is the smallest powder of lead oxide (10 parts), which is kneaded with pork fat (10 parts), olive or sunflower oil (10 parts) and water (Hebra 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 integumentary agent. Some of these drugs have not lost their value at the present time, but not all of them give a positive effect. So, preparations of iodine, silver, lead, having a beneficial effect at the initial stages of treatment, with prolonged use, exacerbate the atrophic process in the nasal mucosa. More effective, not having an inhibitory effect on the nasal mucosa with prolonged use, are herbal preparations containing many vitamins and biologically active substances (sea buckthorn oil, rosehip oil, carotenoline, thuja oil, eucalyptus, etc.). Promising for the treatment of atrophic rhinitis, especially in the presence of trophic ulceration 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 a high activity of the reticuloendothelial system. Solcoseryl contains factors that improve tissue metabolism 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 gumizol 97 ml, sodium salt of 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 clean the nasal cavity from dry crusts and viscous mucus. For this, solutions and ointments of proteolytic enzymes are used for washing the nasal cavity and application exposure.