Vasomotor rhinitis: symptoms and treatment. Anatomy of the nasal mucosa. Sanitation of the nasal cavity

Quite often, people have vasomotor rhinitis. However, this name means nothing to most. But vernacular name diseases" false runny nose' is clear to everyone. What is vasomotor rhinitis, what treatment exists, and how to resist this disease, you will learn from our conversation.

From an anatomical point of view, the nose is designed as a barrier where air is filtered, getting rid of dust, pathogens and other pollutants from the external environment. Its work is so important for our body that any discharge from the nasal cavity, as well as congestion of the passages, should cause us special attention.

In most cases, it is difficult to recognize the true cause of a runny nose. This also includes vasomotor rhinitis. Self-treatment such a disease at home or folk remedies is unacceptable. In this case, consultation with an otolaryngologist should be mandatory and as urgent as possible. General recommendations doctor, you can hear in the next video story.

Causes of the disease and its diagnosis

The difficulty in diagnosing this disease is that it is extremely difficult to distinguish vasomotor rhinitis from the common cold. In each case, secretion is secreted from the nasal passages - a sure sign of rhinitis. However, in our case, there is a violation of the tone of the blood vessels passing through the turbinates, which in turn stops the control of air inhalation.

Among the main causes of the disease, it is necessary to highlight the following:

• changes in the body of a hormonal nature (pregnancy, use of contraceptives, menstrual cycle);
• frequent stress;
• abuse vasoconstrictor drops;
• the use of anti-inflammatory drugs;
• long-term use of medications in the fight against high blood pressure;
• particle irritation environment(dust, allergens);
• weather sensitivity to sharp drops temperature, air humidity, atmospheric pressure;
• various smells;
• spicy food.

However, the treatment of the disease is not as simple as it might seem.

Even in the case of successful identification of the cause of vasomotor rhinitis, it is almost impossible to determine the irritant.

Quite often, the occurrence of vasomotor rhinitis is possible with diseases such as vegetative-vascular dystonia and hypotension.

In the process of diagnosing this disease, the results of laboratory blood tests for the content of eonophils in it, as well as determining the level of immunoglobulin E, are important. important point when diagnosing vasomotor rhinitis, it is the exclusion of its allergic form by the method of carrying out measures to determine the allergen. Quite often, an x-ray of the nasal sinuses is prescribed to exclude or presence polyps in the nasal passages.

Symptoms of the disease

With a disease such as vasomotor rhinitis, the symptoms will manifest as follows:

• persistent and / or periodic nasal congestion (often intermittent);
• periodic occurrence of watery secretions;
• itching in the nasal passages;
• sneezing
• a feeling of some pressure in the depths of the nose;
• headache attacks.

Mentioning the symptoms of this disease, it is necessary to pay attention to the fact that sneezing attacks occur quite suddenly and just as instantly disappear.

The so-called nocturnal symptoms will also indicate this disease. It's about about the constant congestion of the nasal passages due to the strengthening at this time of day of the nervous parasympathetic system. The next specific symptoms relate to the congestion of that part of the nasal passages on which side the patient sleeps. In the case of turning over to the opposite side, congestion gradually passes to it.

Conducting anterior rhinoscopy with a disease such as vasomotor rhinitis, the lower nasal enlarged shells are determined, which have a certain color in the form of gray and white spots. AT this case symptoms of vasomotor rhinitis when feeling with a bellied probe of the lower turbinates are manifested in their softness. The device easily deepens into them without damaging the mucous membrane itself.

Also, the symptoms of this rhinitis will also appear if the turbinates are lubricated with adrenaline, which will be expressed in their sharp reduction. As in the case of ordinary rhinitis, the perception of smells will directly depend on the difficulty of nasal breathing.

Treatment of the disease

Treatment of vasomotor rhinitis involves the weakening of its symptoms. After examination and medical prescription you can treat vasomotor rhinitis at home. AT rare cases hospitalization is required. The fight against the disease occurs by using the necessary nasal drops or sprays that eliminate the signs of this disease.

If the neurovegetative form of this disease is diagnosed, control of work nervous system produced with the help of so-called anticholinergic drugs, for example, Atrovent. You can get rid of burdensome nasal congestion, in the case of vasomotor rhinitis, through the use of drugs such as:

• Budesonide;
• Beclomethasone;
• Mometasone Furoate;
• Intal;
• Cromolyn.

Quite often, the treatment of this disease is carried out by prescribing oral drugs:

In rare cases, successful treatment of vasomotor rhinitis requires urgent surgical intervention, which is the introduction of a certain drug (hormonal or novocaine) into the nasal concha. Sometimes, surgery means removing the blood vessels that cause swelling.

Treatment of the chronic form of the disease

Chronic rhinitis is treated by eliminating the causes that support it in an active form. In most cases, chronic vasomotor rhinitis is provoked by long-term inflammatory processes occurring in the paranasal sinuses. In this regard, the separated pathological secret flows into the nasal cavity, for which it is a powerful irritant. In this regard, vasomotor chronic rhinitis occurs.

As a rule, treatment always concerns the debridement of the affected sinus(s). After this procedure, chronic vasomotor rhinitis disappears completely. In some cases, successful treatment includes active therapy in the fight against obesity and diseases of the kidneys and heart, as well as improving hygiene conditions at work and at home and reducing gas or dust in the air.

At certain conditions catarrhal vasomotor chronic rhinitis can also be treated at home with a 3-5% solution of protargol / collargol, by instillation into each nasal passage 5 drops 3 times a day.

However, in this case, the use of thermal procedures, such as UHF, will be required at the same time. With such a disease, treatment with folk remedies will not allow to achieve the necessary therapeutic effect. When a patient has this disease, it is recommended to periodically visit places with a dry climate.

All treatment in this case will be reduced to a stable decrease in the volume of thickened sections of the mucous nasal passages for full recovery nasal breathing. To choose a rational method in which the treatment will be as effective as possible, it is necessary to establish the degree of hypertrophy of the turbinates. In the case of a small degree, which is determined by lubricating the walls of the nasal mucosa with a vasoconstrictor, the most sparing surgery will be applied, which includes: galvanocaustics and cryotherapy.

If vasomotor chronic rhinitis is extremely pronounced, then partial resection is prescribed in relation to hypertrophied turbinates or conchotomy.

However, the treatment of a disease such as chronic vasomotor rhinitis is symptomatic, which includes monitoring the patient even at home. Irritant therapy is also periodically used, which consists of lubricating the nasal cavity with iodine-glycerin to enhance the activity of the glands of the nasal mucosa.

Application of traditional medicine methods

Treatment of a disease such as vasomotor rhinitis can be carried out with folk remedies. Sometimes they can compete with the most modern medicines. For example, beets or washing the nasal passages with calendula infusion can reduce the abundant secretion of nasal secretions, which also relieves inflammation.

To avoid excessive swelling, the treatment of vasomotor rhinitis with folk remedies occurs with a solution of sea salt, after which eucalyptus oil should be instilled.

You can also restore the reflex reactions of the nasal cavity, as well as the paranasal sinuses, by applying folk remedies by applying red natural clay applications. However, the most famous in the fight against the disease are inhalations carried out over boiled potatoes. With their help, a large number of manifestations of this disease are perfectly removed.

Many ways to heal this disease folk remedies are aimed at general hardening of the body, as well as avoiding stressful situations.

The optimal treatment option: conservative or surgical?

Appropriate treatment, including at home, will depend entirely on the causes of the disease. If the provocateur of vasomotor rhinitis is vegetative-vascular dystonia, then the treatment will be based on drugs that reduce the nervous excitability of the body. After a certain course of treatment, physiotherapy procedures will be additionally prescribed.

It is difficult to treat this kind of disease if you do not pay attention to the normalization of blood circulation in the nasal passages, and also do not ensure the strengthening of the walls of these blood vessels.

At constant use vasoconstrictor drops, it is necessary to completely abandon their use with a gradual decrease in dosage. After all, it is simply impossible to treat this rhinitis. It will help to get rid of such dependence by washing the nasal passages. sea ​​salt, which will constantly tone the mucous membranes of the nasal cavity.

It is better to treat vasomotor rhinitis with traditional means than to endure all the hardships, pain and difficulties of surgical intervention, which will be required in case of failure of conservative treatment.

Predisposing factors

Signs of a runny nose against the background of a violation of vascular tone may appear under the influence of the following factors:

• climate change;
• chemical substances;
• stress;
• pathology of the bronchi and lungs.

In these cases, rhinitis is often temporary. Nasal breathing improves after the elimination of the provoking factor.

Exposure to irritants, such as chemicals, cigarette smoke, or perfumes, can trigger.

Symptoms of the disease

With vasomotor rhinitis, the symptoms are the same as with any runny nose of a non-infectious nature:

• difficulty in nasal breathing due to congestion;
• swelling of the mucous membrane;
• frequent urge to sneeze;
• copious secretion of mucus.

During sleep, the discharge of mucus can drain into the throat, causing discomfort. main feature This type of rhinitis is the congestion of only one nostril during sleep. At the same time, it is worth changing the position, turning over to the other side, the previously blocked nostril is released, but breathing of the second nostril is difficult.

If the disease is provoked by an allergic reaction, it may additionally be present:

• profuse lacrimation;
• mucosal itching;
• eye redness;
• swelling of the skin of the face.

In the evening and at night, the swelling increases, it becomes more difficult to breathe. The disease is accompanied by a deterioration in the sense of smell. Due to congestion, the voice acquires a nasal sound.

Why is vasomotor rhinitis dangerous?

A runny nose needs to be treated. over time leads to sleep disturbance and the appearance of neuropsychiatric disorders - apathy, asthenic syndrome, constant stress. When breathing through the mouth, the tissues of the body, including the brain, receive 20% less oxygen than when breathing through the nose. As a result, a number of violations arise.

First of all, the lack of oxygen affects the functioning of the nervous system, due to which the patient becomes irritable, constantly feels tired and does not relax enough during a night's sleep.

Violation of vascular tone eventually becomes the cause. This leads to the closure of the nasal passage, as a result, breathing is complicated and congestion becomes a constant companion of the patient.

Continuous mouth breathing leads to bronchopulmonary system. As a result, bronchitis and pneumonia develop.

Studies show that chronic rhinitis is accompanied by snoring. The disease is often accompanied sleep apnea (sudden stop breathing) during sleep.

Accurately identify symptoms and treatment for quick recovery vascular tone can only be an otolaryngologist.

Principle of treatment

For the treatment of vasomotor rhinitis in adults, the following groups of drugs are used:

• vasoconstrictor drops for symptomatic treatment;
• glucocorticoids to relieve swelling;
• medicines to improve blood microcirculation;
• antihistamines for the allergic nature of the disease.

Vasoconstrictor drops and are used no more than twice a day. In most cases, it is best to use the product just before bed. If possible, it is recommended to abandon therapy with vasoconstrictor drugs, preferring homeopathic remedies to relieve symptoms (Sinupret drug).

Glucocorticoids for rhinitis

Glucocorticoids are drugs of the hormonal group that have local anti-edematous and anti-inflammatory effects. Vasomotor rhinitis is treated at home with nasal sprays. Effective drugs:

• Nasonex;
• Avamis;
• Sanomen.

How to treat a runny nose with glucocorticoid drugs - it depends on the severity of the symptoms. Preparations, scheme and duration of treatment are selected by the doctor.

Nasonex

This is a synthetic corticosteroid based spray. The remedy reduces swelling and is often used in the treatment of allergic vasomotor rhinitis. The drug is used 1-2 times a day, not more often. The number of clicks on the vial valve determines the dosage of the drug. One click is 50 micrograms of active ingredient. The duration of treatment does not exceed 7 days.

Spray Avamys

It has a pronounced anti-inflammatory effect. Produced in vials with a clearly dosed release of the active substance. The drug is used once a day, two doses in each nostril.

Sanomen

Can be used by patients older than three years. The medicine is indicated for the relief of edema and. The recommended dosage is two clicks on the bottle valve. It is applied once a day.

Long-term therapy with hormonal sprays from the common cold can lead to a number of side effects:

• skin allergic reactions;
• deterioration of the sense of smell;
• nosebleeds.

Before starting treatment, it is necessary to carefully study the contraindications to the use of the drug.

Improvement of blood microcirculation

To normalize vascular tone and improve blood microcirculation, preparations with B vitamins in the composition are indicated. The drug Aescusan is often prescribed. Forms of release - solution and tablets.

The drug normalizes cellular metabolism, strengthens the walls of blood vessels and promotes the restoration of mucous membranes. Thanks to the chestnut extract in the composition, the medicine has a general strengthening effect. It is used as an immunomodulatory agent, but not a medicine for relieving acute symptoms. Analogues - Stugeron, Glivenol. The course of treatment is long, not less than two weeks.

Antihistamine drops

In the allergic form of vasomotor rhinitis, drugs are used that block the production of histamine in the cells of the nasal mucosa - these are drops of Cromohexal and Allergodil.

The drugs are used for a long time, the course of treatment is from two to six weeks. Drops are prescribed for children older than 3-4 years and adults. Medicines can be used for prophylactic purposes before the flowering of plants, the pollen of which irritates the nasal mucosa, thereby provoking an allergic rhinitis.

Nose treatment is carried out 1-2 times a day. The therapeutic effect is manifested several days after the start of treatment.

Antihistamine drops help how to cure vasomotor rhinitis allergic nature and avoid exacerbation of allergy symptoms during the dangerous season.

Nasal lavage

Another effective remedy for treatment is nasal lavage or. To do this, use water in aerosols Aquamaris or Physiomer. Washing is recommended to be done twice a day.

The use of sea water contributes to:

• mucosal hydration;
• reduction of edema;
• relief of inflammation;
• normalization of nasal breathing.

Spray with sea water is recommended for the formation of crusts on the mucosa. Regular rinsing helps remove dust and allergen particles that accumulate in the nasal passage. The antiseptic properties of sea water prevent the development of an infectious rhinitis, which is often observed against the background of vasomotor rhinitis.

Folk remedies

Having figured out how to treat the disease with drugs, many will be interested in alternative therapeutic methods.

Salt washes

To prepare, you need to pour a large spoonful of flowers with a glass of boiling water and boil for an additional 5-10 minutes. It is used as drops (2 drops in each nostril in the morning and in the evening), or for washing.

Honey

The anti-inflammatory and antiseptic properties of honey are widely used to treat rhinitis. different nature. Honey can be used as drops or for washing. Proportions - a tablespoon of honey to two glasses of boiled water.

With vasomotor rhinitis, treatment with folk remedies is carried out only after the exclusion of an allergic reaction.

The prognosis depends on the cause of the common cold. If the violation of vascular tone is due to autonomic dysfunction, you can get rid of rhinitis only after curing the underlying disease. In some cases, despite complex therapy, the disease can periodically return. For an accurate diagnosis, it is necessary to undergo an examination by an otolaryngologist.

Video: Vasomotor rhinitis

Vasomotor rhinitis is a runny nose that is on the list of the most common in humans.

Being chronic, without timely competent treatment, it is able to significantly disrupt the usual way of life, developing into other categories of the disease that are more dangerous to health.

Vasomotor rhinitis is an infectious disease that occurs as a result of negative impact environment (microbes, dust, damp air), which manifests itself in the form of swelling of the tissues of the nasal cavity shell and subsequent copious discharge from the nose. It has different kinds, seasonal to chronic.

In contact with

Distribution of vasomotor rhinitis

The allergic form of rhinitis is not contagious, but a certain group of people has a hereditary predisposition to it. Worldwide, according to statistics, about 600 million people suffer from rhinitis. Among the forms, it occupies a leading position. About 25% of patients in Russia and up to 30% in Europe have this form.

Origin

Mankind has been familiar with the manifestation of this disease since antiquity. Hippocrates was the first to be interested in its explanation. Later, in Rome, the famous physician Galen described the structure of vasomotor rhinitis, without suspecting it. Further works in the study of the disease passed from the Arab physician Aviatsenna, to John Bastok. From Bastok to the Russian doctor L. Silich.

Causes of the disease

Among the causes of vasomotor rhinitis are:

• Infectious lesion - resolves on its own in 50% of cases, however, with possible failures in the work of the immune system, infection is the main cause;
• weather - high humidity, prolonged exposure to the cold can cause complete or partial nasal congestion;
• hormonal changes - women during pregnancy, or during menstrual cycle most susceptible to various allergens, since the attention of the body is drawn to other processes. In most cases, women are affected;
• stress - stressful situation can also provoke an exacerbation of the disease;
• taking medications - when taking a number of drugs, the disease can be mistaken for a side effect.
• constant intake of nasal drops - frequent use This type of drug leads to irritation of the nasal mucosa, as a result, the patient observes complete symptoms.
• environment - gas pollution, dust, strong odors capable of developing vasomotor rhinitis.

Lack of treatment can transform vasomotor rhinitis into chronic form.

Main symptoms

Vasomotor rhinitis occurs when correct operation blood vessels in the nasal cavity. Normally, the nasal concha has a certain size that does not impede the flow of air. As a result of violation of vascular tone and their increased blood supply causes swelling of the mucosa. This leads to the following symptoms:

• Significant difficulty in breathing;
• copious discharge of fluid from the nose;
• complete or partial loss of smell;
• nasality;
• the presence of specific mucus accumulating in the throat;
• feeling of pressure in the sinuses.

With a slight runny nose, are you in a hurry to use expensive medications right away? Find an alternative to them and use for folk treatment.

In the case of an allergic form, the following is added to the list of symptoms:

• Itching and burning;
• redness of the nose, eyelids, lacrimation;
• sometimes - an increase in body temperature.

Types of disease

There are several forms of vasomotor rhinitis:

• Neurovegetative - this form is caused by a violation of the chain of nervous mechanisms. As a result, the mucous membrane reacts with all the abundance of symptoms in response to common stimuli.
• Allergic - caused by contact with the mucous substance-allergen. It is divided into two main types:

■ Seasonal or, as it is also called, "hay runny nose", in most cases associated with the pollen of plants that are in bloom. It is especially acute in spring, when the flowering of allergenic plants is at its peak. If left untreated, it can become permanent.

■ constant - the presence of this form is due to the constant contact of the patient with the allergen. Mostly pets, household chemicals, dust in the apartment. The occurring cases of the "combined allergen" create additional difficulties in the diagnosis and treatment of the disease.

Diagnostic methods

At the initial stage of treatment, a thorough examination by an otolaryngologist is required.

On examination, a group of clinical signs is distinguished:

• Enlargement of the side walls of the nose (edema);
• poor contraction of the walls during breathing;
• the color of the inflamed mucous membrane in red.

Self-diagnosis and prescription of treatment will not relieve the patient of the presence of the disease, but only temporarily help to get rid of the symptoms, without eliminating the need for professional medical intervention.

Complexity correct setting diagnosis outside the doctor's office lies in the fact that vasomotor rhinitis is often confused with allergic. The result of self-treatment is the modification of vasomotor to medication. The patient becomes dependent on vasoconstrictor drops.

Differential Diagnosis

To exclude other diseases, the following steps are performed:

• Taking a blood test from a patient - decoding a blood test can give complete picture about the functioning of the immune system. Detection of an increased level of the leukocentre number of cells (with an allergic form);
• scratch test - scratches are applied to the patient's skin in order to study the effect of applied allergens on the wound. At the site of contact, the reaction manifests itself in the form of swelling, itching or redness;
• the study of nasal secretions - along with the results of a general blood test, the presence of eosinophils can be detected in the analysis of the nasal secretion, which directly indicates the allergic form of the disease;
• x-ray and CT (computed tomography) - often vasomotor rhinitis develops in conjunction with the presence of, and other inflammatory processes in the nasal mucosa. Radiography, as well as CT in a hospital, are able to diagnose such cases.

One of the distinguishing features of this type of disease is the alternate congestion of the sinuses. The sink is laid on the side on which the patient lies most often.

How to treat the disease

Treatment of vasomotor rhinitis has a variety of methods differing in intensity.

At first, the patient is advised breathing exercises. Exercises of this type, carried out several times a day, can partially restore the ability to breathe normally. Basic rules for performing breathing exercises:

• The back should be straight. Forefinger place above the bridge of the nose, large and medium on both sides of the wings of the nose;
• exhale through the nose and close the left nostril with your finger. Inhale as deeply as possible through the free nostril, pinching it at the end. Hold your breath for 10-15 seconds. Repeat with the other nostril.

Important! Exhalation should be twice as long as inhalation. Performing this manipulation, taking into account the rest 10 times a day, you will greatly facilitate your nasal breathing before going to the doctor.

Preparations

• Appointment of antihistamines - despite the fact that they are among the antiallergic drugs, antihistamines successfully suppress the disposition to irritants;
• corticosteroids - most effectively eliminate symptoms. Appointed as long-term treatment to reinforce the positive impact.

Surgical

• Separation of the mucous membrane of the lower part of the nasal concha from the bone. As a result of this, a scar is formed with a further decrease in the lateral nasal cavities;
• photodestructive laser intervention. allocated laser beam heat burns the tissues under the mucosa, causing them to shrink.

Physiotherapy

Treatment with complex treatment will be faster. Therefore, physiotherapy is also prescribed with medication:

• Electrophoresis - exposure to electric current with calcium chloride leads to a positive result after 2 months;
• phonophoresis - ultrasound accelerates blood circulation, acting on the opening of blood vessels. It is used strictly in combination with hydrocortisone ointment;
• acupuncture procedures (acupuncture).

homeopathic remedies not able to fully get rid of this disease. Washing with water and salt, of course, can relieve your condition for a couple of hours, but otolaryngologists around the world would recommend that you spend this time on the road to the office, rather than using this as the main therapy.

Prevention

Preventive measures include:

• Restoration and strengthening of immunity. Taking vitamins A, C and E;
• daily wet cleaning of the house;
• purification of the air from pathogenic bacteria. A certain category of essential oils, with a high probability, can help in their complete destruction;
• ventilation and tempering. Gradual adaptation to low temperatures can smooth out the "shock" of a long stay in the cold.

Forecast

In general, the disease has a favorable prognosis for treatment. It is important to consult a doctor in a timely manner and get appropriate recommendations without wasting time searching for home remedies for getting rid of rhinitis on the Internet.

Conclusion

If symptoms are detected, you should not hesitate to contact an otolaryngologist. Drug treatment and prevention are the most effective in preventing the disease and its recurrence.

Vasomotor rhinitis- This is a disease of the nasal mucosa of non-inflammatory origin, resulting from a violation of the tone of the blood vessels of the nasal cavity and characterized by a chronic runny nose.
A constant runny nose worsens the quality of life and this can even affect the psycho-emotional state of a person: sleep disturbance, inattention at work, increased nervousness, irritability, depression, and the like. Although the disease itself is not particularly dangerous and severe, it requires mandatory treatment, and the sooner the better.

How often does it occur?

It is impossible to say how many people suffer from vasomotor rhinitis due to the fact that not all patients go to the doctors with this problem, but for many years they suffer and “treat” on their own. But many otorhinolaryngologists (ENT doctors) suggest that every third person suffers from this disease or suffered in the past. It is known that vasomotor rhinitis is the most common cause of a prolonged runny nose. And women get sick more often than men.

Some interesting facts:

• The etiology (origin) of vasomotor rhinitis has not yet been accurately studied, only factors that can trigger the onset of vasomotor rhinitis are known.
• Many believe that vasomotor rhinitis is not a disease, but a defensive reaction to a bad environment. This fact confirms that the frequency of this disease has increased dramatically over the period of the last 30-40 years (the period of global progress).
• Vasomotor rhinitis can accompany a woman throughout pregnancy and often occurs even before a woman has learned about her interesting position, and disappears immediately after childbirth.
• Teething runny nose in infants is also vasomotor rhinitis. This can be explained by the presence of inflammation of the gums, which entails local vasodilation and, as a consequence, vasomotor rhinitis.
• Vasomotor rhinitis is one of the most common causes of nocturnal snoring due to enlarged turbinates.
• Sneezing in harsh sunlight is also one of the manifestations of vasomotor rhinitis, as a manifestation of meteosensitivity.
• Taking vasoconstrictor drops (naphthyzinum, nazol and others) during vasomotor rhinitis facilitates nasal breathing temporarily and only contributes to the deterioration of the mucosa.

Anatomy of the nasal mucosa

Nose functions

• Smell(odor recognition), occurs due to the presence of olfactory receptors on the nasal mucosa.
• Breath- the air flow moves in a vortex-like manner through the nasal passages and therefore moves through the nasal cavity more slowly than when breathing through the mouth, this contributes to the performance of other functions of the nose (smell, warming, protection). From the nasal cavity, the air then enters the nasopharynx and through the respiratory tract to the lungs.
• Warming and humidifying the air in the nose is due to the large number of blood vessels suitable for the mucous membrane of the nasal cavity and sinuses. Thanks to this, the lower respiratory organs are protected from hypothermia and dryness.
• Protection respiratory tract from dust, infections and viruses, other foreign particles is carried out due to the ciliated epithelium of the nasal mucosa, the cilia push these foreign particles out of the nose with their movements. This prevents infections from entering the lower respiratory tract.
• Also in the nasal cavity due to abundant blood supply and a large number lymphatic vessels are happening protective immunological reactions against infections and other foreign agents.
• voice resonator, the nose is involved in the formation of the individual timbre of the voice.

Outside, the nose is shaped like a pyramid with three faces.

Parts of the external nose

• Top part external nose: part of the frontal bone, plate ethmoid bone, partially sphenoid bone.
• Side part: nasal bone, frontal process of the maxilla, lacrimal bone, sphenoid bone, cartilages of the nose - lateral cartilages, cartilages of the nasal septum, cartilages of the large and small wings of the nose.
• Bottom part: palatine bone and palatine part of the upper jaw.

The structure of the nasal cavity

Each half of the nasal cavity contains three turbinates(bone processes):

• top,
• average,
• lower.

• AT superior nasal passage mouths open sphenoid sinus and partly the sinus of the ethmoid bone.
• middle nasal passage- in the wall of this passage there is a semilunar cleft, into which the mouths of the maxillary, frontal and ethmoid sinuses go.
• AT inferior nasal passage exits the mouth of the nasolacrimal canal.

Rice. The structure of the turbinates and nasal passages.

Paranasal sinuses (paranasal sinuses)

Functions of the paranasal sinuses

• moisturizing and warming the air when breathing through the nose,
• protection against foreign particles,
• voice resonance,
• lightening the weight of the bones of the skull, which, like a shock absorber, protects the bones of the skull and organs of the head from injury and forms the shape of the face,
• protection of the roots of teeth and eyes from hypothermia when inhaling cold air,
• also involved in odor recognition.

Groups of paranasal sinuses

• Maxillary sinuses (maxillary)- the largest sinuses communicate with the nasal cavity through fistulas located in the middle nasal passage. The maxillary sinuses are located in the upper jaw to the right and left of the nasal cavity. The infraorbital nerve passes through this sinus.
• Frontal sinuses are located in the frontal bone above the brow ridges, usually there are two of them, but sometimes one. The fistulas of the frontal sinuses exit into the middle course of the nasal cavity.
• Sinuses of the ethmoid bone have varied form, plates of the ethmoid bone divide this cavity into such cells. There are anterior and posterior ethmoid sinuses. The fistulas of the anterior ethmoid sinuses open into the middle nasal passage, and the posterior sinuses - into the upper nasal passage.
• Sphenoid sinuses located in the sphenoid bone above the upper nasal passage. The fistulas of the sphenoid bones exit into the superior nasal passage.

Anatomical and physiological features of the paranasal sinuses in children

• a child is born with sinuses, which are small vesicles, pits, cells; in the process of growth, the paranasal sinuses are formed;
• The paranasal sinuses are fully formed by the age of 15, and frontal sinuses even by the age of 20.

Rice. Scheme of the paranasal sinuses.

Nasal mucosa

Sections of the nasal mucosa:

• olfactory,
• respiratory (respiratory).

Olfactory part of the nasal mucosa

In the thickness of this epithelium there are olfactory glands with outgoing olfactory cilia, to which olfactory receptors are suitable. These receptors are very specific and able to recognize great amount odors.

The mechanism of the olfactory function of the nose of the nasal mucosa

• molecules of smelling substances reach the olfactory cilia and specific receptors of the nasal mucosa, binding to them;
• the impulse passes to the threads of the olfactory nerve, which pass through the holes in the ethmoid bone;
• two olfactory bulbs unite nerve threads, are the primary olfactory centers, are located in the cortex lower divisions hemispheres, in which the primary analysis of the smell takes place;
• after the initial analysis of the smell, the impulse is transmitted to the cortex of the surfaces of the temporal lobes - to the higher section of the olfactory analyzer.

Factors affecting the ability to recognize odors

• inflammatory processes, edema (infections, viruses, allergies, vasomotor rhinitis),
• with constant inhalation harmful substances: smoking, smoke, dustiness, dry air, frequent use disinfectant solutions and other chemicals,
• after prolonged exposure to the nasal mucosa of pungent odors, such as perfume, hot pepper and others.

The function of olfactory receptors is directly related to the work of taste buds located in the oral cavity.

Respiratory mucosa of the nasal cavity

The respiratory epithelium performs the function breathing air treatment.

Characteristics of the respiratory department of the nasal cavity

• The respiratory section of the nose is lined with ciliated epithelium, contains a large number of cilia, on which foreign particles from the inhaled air (dust, smoke, bacteria) settle. Retained particles are removed from the nasal cavity with mucus using oscillatory movements of these cilia towards the nostrils or pharynx.
• In the respiratory epithelium there are mucous glands that produce special mucus. Mucus on itself retains dust particles and microbial bodies. With the help of cilia, mucus is removed from the nasal cavity.
• The walls of the paranasal sinuses are lined with the same mucous membrane.
These three features of the nasal mucosa provide the protective function of the nose.

• A large number of vessels approach the nasal mucosa - the venous plexus. As a result, the inhaled air is heated. It is the state of these vessels that determines the development of the common cold, especially with vasomotor rhinitis.

• A large number of vessels, more than in many organs, such as the liver, muscles and others, a high level of microcirculation.
• Vascular mobility provided by the sympathetic and parasympathetic nervous system, as well as the unique structure of the capillaries. Mobility of vessels is necessary for their adaptation to various factors.
• Developed microcirculation nasal mucosa provided copious amounts connections (anastomoses) of arterioles and venules, which performs the function of warming and moistening the inhaled air, and also provides the nasal mucosa with immune cells from the vascular bed.
• The formation of venous plexuses(dense network venous vessels), resembling cavernous formations, are veins with elastic walls, located between arterioles and venules. Venous plexuses are able to expand under the influence of various factors ( high blood pressure, inflammatory processes, allergic rhinitis and others), while swelling of the nasal mucosa.
• The presence of the trailing arteries and throttling veins(vessels with peculiar valve devices) are involved in filling the vessels of the venous plexus.

Blood supply to the outer wall of the nose

• angular artery from the facial artery, which is a branch of the external carotid artery;
• dorsal artery(arteries of the back of the nose) from the ophthalmic artery, which is a branch of the internal carotid artery.

Blood supply to the nasal cavity

• posterior nasal lateral and septal arteries - branches of the sphenoid-palatine artery from the maxillary and facial arteries, which is a branch of the external carotid artery;
• anterior and posterior ethmoid arteries from the ophthalmic artery, which is a branch of the internal carotid artery.

Paranasal sinuses are supplied with blood by the same vessels as the nasal cavity.

Venous drainage of the nasal cavity

• Angular vein flows into deep vein face, connected with the pterygoid plexus, then into the maxillary and facial veins, which drain into the internal jugular vein.
• inferior ophthalmic vein together with the superior ophthalmic vein flow into the cavernous sinus, and then into the jugular vein. Through the cavernous sinus, the nasal cavity is connected with the vessels of the brain.

Regulation of vascular tone of the nasal cavity

• autonomic nervous system - vasomotor centers of the brain and spinal cord through the autonomic nervous system transmits impulses to receptors located in the smooth muscles of the vascular wall, regulating the tone.

  There are sympathetic and parasympathetic autonomic nervous systems. These sections of the autonomic nervous system have opposite effects in relation to each other, if one section stimulates, then the other depresses. Thus, the regulation of the work of each organ, including blood vessels, is carried out.

  • Sympathetic innervation the nasal cavity is carried out by the fibers of the cervical sympathetic ganglion as part of the second pair trigeminal nerve(maxillary nerve).
  • Parasympathetic innervation carried out by the nerve of the pterygoid canal, which is a branch pterygopalatine node.
• Humoral factors - regulation of the tone of the vessels of the nose due to the production of hormones and other biological active substances and mediators:
  • Vasoconstrictor substances- adrenaline, norepinephrine, vasopressin, serotonin, renin and others. Many of these substances react with nosebleeds to stop them.
  • Vasodilators- bradykinin, prostaglandins, histamine and others. Many of them are released during the inflammatory process as a result of a viral or bacterial infection, allergies.
  These biologically active substances are secreted by the central nervous system, endothelial cells of the vascular wall and many tissues of the body in response to the influence of external or internal factors, are involved in maintaining homeostasis (maintaining the normal state of the body).
• Local mechanisms of blood circulation regulation lie in the ability of cells to secrete biological active substances and mediators, as well as in the special structure of the vessels of the nasal cavity. Venous plexuses, relay arteries, throttling veins are able to regulate the blood filling of the nasal cavity (such a valve mechanism for depositing blood in the veins).
• Blood pressure and circulating blood volume contribute to the expansion or narrowing of the vessels of the nasal cavity and lead to tone smooth muscle vascular wall.

Causes of vasomotor rhinitis

• Violation of the regulation of vascular tone of the nasal cavity,
• Expansion of the venous plexuses,
• swelling of the nasal mucosa,
• As a result - thickening of the nasal mucosa, swelling, damage to the ciliated ciliated epithelium, disruption of the mucous glands, changes in the olfactory epithelium. In this case, the nasal cavity ceases to fully perform its functions.

Almost every person faces the factors contributing to the development of vasomotor rhinitis, but not everyone suffers from vasomotor rhinitis, why this happens, the reason for this scientists has yet to be studied.

Factors contributing to the development of vasomotor rhinitis

1. Viral infections- one of the most common causes, a trigger for the development of vasomotor rhinitis.

   When the virus replicates (penetrates into the cytoplasm of the cell by embedding its genetic material - RNA) into the cells of the nasal mucosa, the epithelium is infected and a protective reaction is triggered - the immune response. The immune response is always accompanied by inflammation, and inflammation is accompanied by edema, vasodilation, disruption of the mucous glands (mucus hyperproduction - runny nose). The inflammatory process stimulates the receptors of the autonomic nervous system, the release of hormones and other active substances and mediators. The virus quickly leaves the cells of the nasal mucosa (after 3-14 days), and the regulation of vascular tone is already impaired and this can lead to the development of a chronic process - vasomotor rhinitis.

2. The quality of the air you breathe. Many scientists suggest that vasomotor rhinitis is a reaction to polluted air.

   Characteristics of inhaled air that can lead to the development of vasomotor rhinitis:

   • cold and hot air
   • dry or humid air
   • climate change, weather,
   • smoking,
   • dustiness,
   • inhalation of strongly odorous substances,
   • inhalation of air with impurities of toxic gases.
   When such air is inhaled, a reflex expansion of the vessels of the venous plexus occurs, hyperproduction of mucus by the mucous glands. Healthy individuals may also develop mucus overproduction as normal reaction on polluted air, but in those suffering from vasomotor rhinitis, these manifestations are more pronounced and persist for a longer period. These factors affect the local and neurogenic regulation of vascular tone.
3. emotional stress is always accompanied by the release of a large amount of hormones into the blood, which leads to a sharp narrowing of the vessels, with decompensation of the narrowed vessels, they expand and disrupt the humoral link in the regulation of the vessels of the nasal cavity. Any stress also leads to disruption of the nervous system, which also regulates vascular tone.
4. Misuse of vasoconstrictor drugs(naphthyzinum, farmazolin, nazol, nazivin, knock spray and many others) is also a common cause of chronic rhinitis. All instructions for nasal drops with a vasoconstrictive effect indicate a course of treatment - up to 7 - 10 days. With frequent and prolonged use, the production of its own vasoconstrictive active substances is inhibited - addiction occurs, that is, in the absence of these drops, the vessels of the mucous membrane are in an expanded form, that is, vasomotor rhinitis appears.
   
5. Taking certain medications, such as:
   • Non-specific anti-inflammatory drugs (aspirin, ibuprofen, nimesulide and others),
   • Beta-blockers - means to lower blood pressure (phentolamine, methyldopa, prazosin and others).
   These drugs contribute to an increase in the volume of circulating blood in the vessels of the nasal cavity, and as a result, their expansion, and also affect the work of the autonomic nervous system, contributing to the disruption of the regulation of vascular tone.
   
6. Presence of atopic (allergic) diseases(atopic dermatitis, bronchial asthma and others) increase the risk of developing atopic vasomotor rhinitis. The mechanism of development of vasomotor rhinitis in atopy is to increase the permeability of the vessels of the nasal cavity, as a result - swelling of the nasal mucosa.
   
7. Hormonal changes in the body:
   • taking contraceptives,
   • adolescence ( puberty) in girls.
   In the presence of hormonal disorders in the body during physiological or pathological processes (namely, an increase in the level of estrogens - female sex hormones), a violation occurs humoral regulation vascular tone.
   • diseases of the hypothalamus, adrenal glands and other organs of the endocrine system with imbalances of hormones involved in the regulation of vascular tone.
   
   
8. Adenoid and other growths, the presence of anatomical defects in the nose, nasal trauma interfere with the normal passage of air flow in the nasal cavity and / or compress the vessels of the nasal mucosa, which leads to stagnation of blood in the venous plexuses, disrupting local regulation of vascular tone.
   
9. Vegetative-vascular dystonia and arterial hypertension - vascular diseases, accompanied by an increase or decrease in blood pressure, associated with disruption of the autonomic nervous system. Under the influence of the abnormal work of the neurogenic factor of vascular regulation, narrowing or expansion of the arteries and expansion of the venous plexuses occur, as a result - swelling of the nasal mucosa and chronic runny nose.
   
10. Teething in babies and extraction of teeth in adults. In the presence of an inflammatory process in the oral cavity, vasodilation, swelling and irritation occur. nerve endings and the nasal cavity, as partly there are common blood supply and innervation.
    
11. Eating spicy and spicy foods, drinking alcohol cause temporary vasomotor rhinitis by stimulating the taste buds, which are interconnected with the olfactory receptors of the nose. Through the nasopharynx, the molecules of such food enter the nasal cavity, and a reflex expansion of the venous plexuses occurs.
    
12. Diseases of the digestive system, especially the stomach, which are accompanied hyperacidity or reflux of gastric juice into the esophagus. Molecules of gastric juice irritate the receptors of the nasal cavity, affecting the neurogenic factor in the regulation of vascular tone.

Forms of vasomotor rhinitis:

• Neurovegetative form develops in violation of the regulation of vascular tone of the entire bloodstream or only the vessels of the nasal cavity.
• allergic form:
  • Seasonal allergic rhinitis(for example, hay fever pollinosis - allergy to plant pollen)
  • Perennial allergic rhinitis(eg allergic to house dust, animal hair, bird feathers, library dust, etc.).

In the neurovegetative form of vasomotor rhinitis, no immune reaction occurs, while in the allergic form, an increase in the level of immunoglobulin E, an increase in the number of eosinophils, and positive allergy tests are always detected.

Symptoms of vasomotor rhinitis

Exacerbations of chronic rhinitis usually begin abruptly, and can also disappear abruptly. The duration of the disease - from several hours and days to several years, seasonal allergic rhinitis can accompany a person throughout his life.

Stages of vasomotor rhinitis

1. stage of periodic attacks,
2. stage of prolonged seizures,
3. stage of polyp formation,
4. fibrosis stage.

Diagnosis of vasomotor rhinitis

Patient Interview

Criteria for the diagnosis of vasomotor rhinitis when interviewing a patient:

• The presence of symptoms of vasomotor rhinitis: nasal congestion, sneezing, itching of the nasal mucosa and others.
• Exacerbations of the common cold occur immediately after exposure to factors, contributing to the development of vasomotor development ( viral infection, inhalation of cold air, dustiness, meeting with an allergen and many others);
• Disease duration- vasomotor rhinitis lasts a long time, patients often turn to the doctor after years of illness, the disease flows in waves, periods of exacerbation are replaced by a period of remission, sometimes a runny nose does not stop at all.
• Presence of comorbidities: vegetative-vascular dystonia, arterial hypertension, hormonal disorders, atopic diseases (allergies) and others.
• Taking medications:oral contraceptives, anti-inflammatory drugs, addiction to vasoconstrictor drugs, drugs that reduce arterial pressure.
• Pregnancy, adolescence, exacerbations during menstruation among women.

During a general examination of the patient:

• the general condition is usually not disturbed, but the patient may be irritable, tired,
• breathing through the mouth or noisy through the nose,
• mucous or watery discharge from the nose,
• frequent sneezing,
• redness of the nose and eyes.

Rhinoscopy

Types of rhinoscopy:

• Anterior rhinoscopy- the nasal mirror is inserted into the nose to a depth of 1-2 cm in a closed form, and in the anterior parts of the nose, the branches of the mirror open. Using this method, the anterior sections of the nasal septum, the lower choana, the lower and common nasal passages are examined. When changing the position of the head, you can examine the anterior part of the middle choana and middle nasal passage.
• Average rhinoscopy - a nasal mirror with long branches is inserted below the middle turbinate. This manipulation is carried out with preliminary treatment with anesthetics and vasoconstrictors. Using this method, the middle concha and the middle nasal passage are examined.
• Posterior rhinoscopy - nasopharyngeal speculum is inserted through oral cavity to the back wall of the pharynx and with the help of a fiberscope examine back departments turbinates and passages, choanae. This manipulation is best done after pre-treatment of the nasopharynx with anesthetics in order to prevent the gag reflex.

1. During the period of remission changes at a rhinoscopy do not come to light. Anatomical defects of the nose, adenoids, polyps and other growths can be identified.
2. Exacerbation period:
   • nasal mucosa edematous, cyanotic and hyperemic;
   • enlargement of the turbinates, sometimes they can completely block the nasal passages;
   • in the nasal passages there is a large amount of mucus;
   • vessels are dilated, react to the treatment of the mucosa with vasoconstrictor drugs.
3. Period of prolonged seizures:
   • the mucosa becomes pale, grayish, contains fine-grained formations (thickening of the mucous membrane);
   • turbinates are enlarged;
   • changes in the olfactory zone nasal cavity;
   • venous plexuses are dilated, additional vascular connections (anastomoses) are created, the vessels do not respond to vasoconstrictors.
4. Period of polyp formation:
   • polyps- sac-like hanging growths from the mucous glands, more often detected in the middle nasal passage, these growths sometimes completely block the nasal passages;
   • degenerative changes mucous membrane, including olfactory department;
   • dilated vessels do not respond to vasoconstrictor drugs.
5. Fibrosis period:
   • tissues of the nasal mucosa and vessels are fibrosed (sprout connective tissue);
   • polyps are covered with fibrous tissue;
   • the appearance of calcifications is possible (connective tissue with calcium inclusions, such a pebble);
   • the nasal cavity almost completely ceases to fulfill its functions.

Laboratory diagnostics for vasomotor rhinitis

1. General blood analysis in the neurovegetative form of vasomotor rhinitis, it is usually normal. In the allergic form, there may be eosinophilia (an increase in the level of eosinophils, the norm is from 1 to 5%).
2. Increasing the level of immunoglobulin E in the blood (the norm is up to 165 IU / ml) is observed only in the allergic form of vasomotor rhinitis.
3. Allergy tests carried out with an allergic form of vasomotor rhinitis in order to determine the allergen that causes bouts of the common cold.

   Types of allergy tests:

   • Skin tests- applying the allergen in low concentration to the skin with a needle or scarifier. If there is an allergic reaction to a particular allergen, a local skin reaction.
   • Determination of specific immunoglobulins G to allergens - laboratory analysis blood serum. Tablets are used - sets of allergens. With allergic rhinitis, it is necessary first of all to conduct a study to allergens of plant and animal origin.
4. Immunogram carried out to assess the state of immunity. Usually it is changed in the allergic form of vasomotor rhinitis.
5. Sowing discharge from the nose and nasopharynx for pathogenic flora necessary to exclude the addition of a secondary infection and differential diagnosis with infectious rhinitis and sinusitis. When pathogenic flora is detected, sensitivity is carried out this pathogen to antibiotics, to further determine the further tactics of antibiotic therapy.
6. X-ray of the paranasal sinuses with repeated attacks of vasomotor rhinitis, it can be changed - darkening of the maxillary sinuses, due to mucosal edema and hyperfunction of the mucous glands, the formation of polyposis growths.
7. Additional Research in order to determine concomitant pathology (measurement of blood pressure, electroencephalogram, electrocardiogram, determination of hormonal levels, and others) according to indications.

Treatment of vasomotor rhinitis

You should not self-treat vasomotor rhinitis with vasoconstrictor drugs, as this will only bring temporary relief and will contribute to the development of addiction to them.

Even with a common cold, vasoconstrictor drugs should not be used for more than a week, and if the runny nose has not gone away, it is better to replace nasal drops with complex drops containing an antibiotic, hormone, biostimulants and antiallergic drugs or other types of drops.

Eliminate Factors that provoke attacks of vasomotor rhinitis, if possible. Of course, in most cases, this fails. We can't improve the air, stop people from wearing perfume, completely eliminate house dust, and stop plants from blooming. Yes, pregnancy and menstruation are normal condition women. But we can humidify the air in the room, carry out regular wet cleaning at home, treat vegetative-vascular dystonia and others. accompanying illnesses, control blood pressure, replace "problem" drugs with other means, and so on. And if vasomotor rhinitis aggravates due to adverse working conditions, you can increase individual means protection from allergens or other factors, and if this is not possible, then change jobs.

Sanitation of the nasal cavity

Salt solutions thin the nasal mucus, making it easier to rapid withdrawal it from the nasal cavity and the normalization of the work of the cilia of the ciliated epithelium of the mucosa. Also, a saline solution with the help of osmosis relieves swelling of the mucous membrane.

AT pharmacy network a large number of mineral nasal rinses are offered, but regular saline solution (0.9% sodium chloride solution) can also be used, cheaply and effectively.

How to wash the nose?

It is recommended to rinse the nose several times a day, especially after contact with possible factors (dust, allergens, etc.). The nose is washed with saline solutions by instillation, rinsing with a syringe, a teapot, and special devices that go to the preparations for washing. Some people manage to rinse their nose out of a plate, cup, and so on.

After such washing, other nasal agents can be used, this improves their penetration into the mucosa.

Also, for sanitation, solutions of antiseptics, antibiotics, antiviral and antiallergic drugs are injected into the nasal cavity. Most often, this contributes to a quick recovery without hormone therapy and surgical intervention.

Conservative treatment of vasomotor rhinitis

If a conservative treatment did not give the expected effect, then it is possible to introduce some substances directly into the mucous membrane (injections):

• Novocaine blockade - the introduction of novocaine into the mucosa of the lower nasal concha, promotes vasoconstriction, by suppressing the sensitivity of their receptors.
• Intramucosal administration of corticosteroids.

Surgery

Methods surgical treatment with vasomotor rhinitis:

• Septoplasty - operations to align the nasal septum, removal of adenoids and other formations in the nasal cavity,
• partial excision of the vessels of the mucous membrane of the lower turbinates (submucosal vasotomy),
• electroplasma coagulation- destruction of blood vessels with the help of a coagulator;
• ultrasonic disintegration– destruction of dilated vessels by ultrasound,
• laser destruction dilated vessels.

Physiotherapy

Physiotherapeutic procedures for vasomotor rhinitis:

• phonophoresis with hormonal drugs - the use of ultrasound on the cells of the mucous membrane of the nasal cavity and nasal vessels, normalizes the tone of the vessels, restores the damaged mucous membrane and the functioning of the mucous glands and cilia, the most effective method physiotherapy.
• electrophoresis with calcium chloride - strengthens the wall of blood vessels, increases their tone and resistance, relieves swelling, and contributes to the normalization of the function of the venous plexuses.
• laser therapy- relieves swelling of the mucous membrane, normalizes local mechanisms of regulation of vascular tone, most effectively in relation to arterioles and venules.
  Physical procedures are carried out daily for 10-12 days.

Lifestyle and nutrition in vasomotor rhinitis

• Hardening - best tones and trains blood vessels. It must be started in the summer with a gradual decrease in the temperature of the water for washing, bathing, dousing.
• Physical exercise stimulate blood vessels, prevent the development of hypertension, obesity, vegetative-vascular disorders. It is best to give cardio (running, cycling, walking, dancing, jumping in place, etc.).
• Healthy sleep - an adult should sleep at least 8 hours at night.
• Walks in the open air.
• Normal emotional state"nerve cells are not restored", it is better not to be nervous.
• Quit smoking and alcohol will help not only strengthen blood vessels, but will also be useful for the heart, lungs, liver and the whole organism as a whole.
• Body weight support. Abrupt changes body weight in plus or minus kilograms can also disrupt vascular tone.
• Proper nutrition with the exception of foods containing a large amount of cholesterol. The diet should be balanced, contain enough calcium and other trace elements, vitamins of groups B, A, E, and C, polyunsaturated amino acids.

  Products that contribute to the fastening of blood vessels:

  • Fish and other seafood - contain a large amount of polyunsaturated amino acids and trace elements.
  • Vegetables: beets, cabbage, eggplant, green vegetables, carrots, tomatoes and others.
  • Fruits: citrus fruits, apples, banana, grapes and others.
  • Berries: currants, raspberries, pumpkins and others.
  • Legumes.
  • Juices, fruit drinks.
  • Gelatin, pastille.
• Characteristics of food consumed:
  • The temperature of food and drinks should be comfortable, warm. cold and hot food provokes the expansion of the vessels of the nasal cavity.
  • People with vasomotor rhinitis should avoid spicy and spicy foods.
• Annual medical examinations necessary for timely detection and treatment of various diseases of the respiratory tract, cardio - vascular system, digestive tract, hormonal diseases, neoplasms, infectious processes and many others.

Consequences and complications of vasomotor rhinitis

• Recovery at effective treatment and / or elimination of the causes that provoked attacks of exacerbation of the common cold. The most common outcome of vasomotor rhinitis.
• Transition to the chronic form, recurrence of seizures when meeting with provoking factors.
• Complicated course of vasomotor rhinitis.

1. Frequent infectious diseases of the upper respiratory tract and lungs with vasomotor rhinitis are associated with inadequate functioning of the nose and breathing through the mouth (the air is not cleaned, not warmed).
2. The development of bacterial rhinitis and sinusitis (purulent sinusitis, frontal sinusitis), since with vasomotor rhinitis a secondary bacterial infection.
3. Hearing impairment due to the inflammatory process in the Eustachian (auditory) tube, which goes into the nasopharyngeal cavity.
4. The formation of polyps (overgrowth of the mucous membrane of the nasal cavity and accessory sinuses), the third stage of vasomotor rhinitis requires mandatory surgical treatment, they do not go away on their own.
5. Fibrosis of the mucosa and carnification - germination of the mucous membrane and polyps with connective tissue, complete cessation functioning of the nose as such. Requires mandatory surgical and physiotherapy treatment, the prognosis is unfavorable.

Vasomotor rhinitis - what kind of pathology is it? Vasomotor rhinitis is chronic inflammation in the nasal mucosa, which is based on a violation of the neurohumoral regulation of the vascular wall of the vessels in the nasal cavity.

At the heart of the occurrence of vasomotor rhinitis are persistent changes in the walls of blood vessels located in the nose. As a rule, it is not possible to single out one cause of this disease. Sometimes it is not possible to identify it at all. But there are a number of factors that contribute to the occurrence of this disease. They can be roughly divided into 2 groups:

External factors:

• Environmental pollution and inhalation of polluted air;
• Weather: big difference in temperature, atmospheric pressure and its differences;
• Dry indoor air;
• Professional conditions that force you to work in adverse conditions(dust, air pollution, etc.);
• Taking certain medications, for example, vasoconstrictor drops, hormones, NSAIDs, oral contraceptives, antidepressants;
• Passive or active smoking;
• Chronic exposure to stress.

Internal factors and concomitant diseases:

• Hormonal imbalance: it can occur during pregnancy, lactation, puberty, menopause, as well as in the presence of concomitant endocrine pathology;
• Polyps in the nose;
• Adenoids in children;
• deviated nasal septum;
• Vegetative-vascular dystonia;
• Hypotension;
• Bronchial asthma;
• Trauma to the nose.

Symptoms

Vasomotor rhinitis belongs to the category of chronic diseases that slowly but steadily progress. And if at first the patient may hardly notice any complaints, then later they will appear. Due to swelling of the nasal mucosa, ventilation is not as efficient as it should be, therefore, over time, the patient will begin to notice manifestations of a lack of blood supply to the brain, which include:

• Dull headaches;
• Fatigue;
• Decreased memory and attention;
• Dyssomnia (sleep disorder);
• lethargy;
• Depressed mood;
• Decreased appetite.

In addition, due to persistent swelling of the nasal mucosa, vasomotor rhinitis is characterized by the following symptoms:

• Nasal congestion: may stop breathing, then the left, then Right side. A person most clearly feels this when lying down: the nostril is on the side on which the patient is located, and stops breathing. When turning, the situation is reversed;
• Pathological discharges from the nose are colorless and odorless, they are quite abundant and not thick;
• The mucus that is produced in the nose can get into the throat, irritating it and causing a reflex cough and a feeling of "coma";
• Decreased sense of smell.

Classification

There are two main forms of vasomotor rhinitis:

Neurovegetative

The basis of this form of rhinitis is a violation in the regulation of the tone of the vascular wall from the side of the nervous system. The disease proceeds in the form of attacks, which most often occur in the morning. Any irritant can serve as a provocation. However, during the remission period, all subjective and objective signs disappear.

allergic

This form of vasomotor rhinitis is further divided into two different types:

• Seasonal rhinitis. This type of rhinitis has another name - hay fever. It is based on seasonality, that is, a certain frequency of occurrence of seizures. The most common cause of seasonal rhinitis is the pollen of various flowering trees and plants. As they bloom in certain period time, then the manifestations will correspond to the entire flowering period. If there are several allergens, then the duration of the attack period increases.
• Persistent rhinitis. This type The disease is characterized by the lack of connection of attacks with some time of the year. In this case, any substances that surround a person and contact with which he can occur on any day can serve as an allergen: house dust, perfumes, household chemicals, etc. With constant contact with the allergen, the runny nose becomes chronic and is observed throughout the year, which makes it difficult to treat.

Depending on the course of vasomotor rhinitis, it is customary to distinguish 4 degrees of severity:

Stage I (periodic seizures)

The most initial and, accordingly, the most meager symptoms: nasal congestion may occur periodically, there are periods of complete remission, when nothing bothers, and periods of exacerbation (after SARS, contact with an allergen), when swelling and congestion appear.

Stage II (prolonged seizures)

At this stage, vasomotor rhinitis acquires a chronic course and structural changes in the mucous membrane appear in the nasal cavity. Nasal congestion is longer, periods of remission are reduced.

Stage III (polyp formation)

There is a further progression of the process, which leads to the formation of polyps in the nose.

Stage IV (fibrosis)

Polyps become covered with connective tissue, taking up more and more space and making breathing difficult. It now becomes possible only through the mouth. In addition, the mucous membrane in the nose becomes dense.

Complications

• Acute or chronic sinusitis. Long selection pathological secretion can enter the sinus cavity, causing inflammation there. Signs of a complication of the disease will be the appearance of headaches and soreness in the places of the paranasal sinuses.
• Otitis media. When the infection enters the middle ear, the patient will feel pain in the affected ear.
• polyp formation. Polyps - growths of the epithelium of the nasal mucosa. The process itself is benign, but these growths block the lumen of the nasal passages, as a result of which the patient can only breathe through the mouth. Unfortunately, when there is this complication only surgical methods of treatment will be effective.
• Sleep apnea syndrome. Due to the fact that breathing through the nose is difficult, the patient may experience episodes of short-term respiratory arrest at night, which negatively affects the brain, which experiences a sharp lack of oxygen.

Diagnostics

In order to establish the diagnosis of "vasomotor rhinitis", it is necessary to exclude other causes that can cause chronic rhinitis.

First, the doctor asks the patient's complaints and focuses on the frequency of congestion, congestion in one or two nostrils at once, the quality of the secreted mucus, the relationship of symptoms with the season, climate change and other factors.

The doctor also asks the patient about the presence of concomitant diseases (VSD, endocrine pathology, pregnancy, etc.), and what medications he takes (oral contraceptives, antihypertensives, etc.).

This is followed by an objective examination. Noteworthy is the absence of a temperature reaction, the satisfactory condition of the patient. The nose may be reddened due to irritation with mucous secretions.

Then the nasal cavity is examined - rhinoscopy. For vasomotor rhinitis, the following symptoms will be characteristic:

• swelling and hyperemia of the nasal mucosa, it has a bluish tint;
• an increase in the size of the turbinates;
• the vessels are dilated;
• mucous secretion in the nasal cavity;
• A deviated septum, polyps can be detected.

From laboratory methods appoint general analysis blood, which in the presence of only allergic rhinitis will show an increased content of eosinophils. Otherwise, it will remain unchanged.

Treatment

Treatment of vasomotor rhinitis should be carried out in accordance with many parameters: the cause that caused the disease, the form of rhinitis and the stage of the course.

The first thing to start with the treatment of vasomotor rhinitis is to eliminate the root cause, if it is found and can somehow be influenced.

So, if the cause is taking certain medications, then you can replace the drug (if possible, cancel it), if the allergy is caused by certain perfumes, stop using them, etc. You can maintain humid air, treat concomitant diseases, as all this will help to cope with the pathology.

Unfortunately, it is not always possible to eliminate the cause. It is about changes in atmospheric pressure, climate in general, pregnancy and menopause, which cannot be influenced.

Conservative treatment

Conservative treatments include the following:

Vasoconstrictor drops. On the early stages it is possible to use vasoconstrictor drops for up to 5 days. Exceptions are cases where the development drug rhinitis or in pregnant women.

Salt (physiological) solutions - salin, aquamaris. Need to use for washing the nasal cavity, suitable for long-term use.

Sprays and nasal drops containing GCS (corticosteroids) - they are used for a long course for one month or more. These drugs are safe for humans. The hormone contained in the drug is not absorbed into the blood, does not enter the systemic bloodstream, and therefore does not have systemic effects. adverse reactions for the body. The effect of their use does not develop immediately, however, these sprays do not relieve symptoms, namely, they treat the disease. They have anti-inflammatory and anti-edematous action. Dosage regimen: one injection in each nostril in the morning.

Nasal sprays containing anti-allergic components - vibrocil, allergodil. Such sprays reduce the amount of production of substances that dilate blood vessels and causing swelling thereby reducing it and making breathing easier. Effective in allergic form of vasomotor rhinitis. Dosage regimen: 1 injection into each nostril twice a day for 1-2 months.

Anticholinergics in the form of a nasal spray (ipratropium bromide), a drug that is traditionally used to treat bronchial asthma, is effective in the treatment of vasomotor rhinitis due to vasoconstriction. Dosage regimen: 2 sprays for each nostril three times a day.

Antihistamines - loratadine, claritin, lordes. These drugs are suitable for the treatment of allergic rhinitis. Dosage regimen: 1 tab. per day.

Physiotherapeutic methods - electrophoresis, ultrasound are used.

Surgical treatment

Surgical treatment includes the following methods:

• Endoscopic removal of polyps;
• Vasotomy (sclerosis of the vessels of the nasal mucosa);
• Radiofrequency ablation of the region of the lower conchas of the nose;
• Destruction using ultrasound of the inferior turbinates;
• Correction of a deviated nasal septum;
• Cryodestruction of the lower conchas of the nose;
• Galvanocaustics.

The purpose of the above surgical interventions is the incomplete destruction of blood vessels, reducing swelling of the nose and, as a result, facilitating free breathing through the nose.

Folk methods of treatment

Traditional medicine can come to the rescue if other methods are associated with certain risks, i.e. in children and pregnant women, as well as as an addition to complex treatment.

It is possible to apply for the purpose of washing the nasal passages with vasomotor rhinitis:

• Beetroot juice;
• Aloe juice;
• Decoction / infusion of chamomile;
• Decoction / infusion of calendula;
• Decoction / infusion of hawthorn;
• Decoction / infusion of nettle flowers;
• Saline;
• Birch juice.

To lubricate and soften the nasal mucosa, you can use:

• fir oil;
• Sea buckthorn oil;
• Walnut oil 10%, the basis of which is Vaseline.

Vasomotor rhinitis is a sluggish but very unpleasant disease that can significantly affect the patient's quality of life. Only a doctor after complex diagnostics will be able to determine the cause and prescribe adequate treatment to help control the disease.