- What is vasomotor Rhinitis
- What triggers / causes of vasomotor Rhinitis
- Pathogenesis (what is happening) during vasomotor Rhinitis
- The symptoms of vasomotor Rhinitis
- Diagnosis of vasomotor Rhinitis
- Treatment vasomotor Rhinitis
- Which doctors should be consulted if You have vasomotor Rhinitis
What is vasomotor Rhinitis -
Vasomotor rhinitis is sometimes defined as vasomotor-allergic rinosinusopatia or angioedema.
What triggers / causes of vasomotor Rhinitis:
The development of the disease contribute to the curvature, spikes and ridges of the nasal septum, adenoids, polyps, foreign body, disorder of the gastrointestinal tract, a long cooling time. The disease are altered reactivity and breakdown neurovegetative and endocrine mechanisms, immunoselection dystonia, cardiovascular neurosis with a predominant manifestations in the nose area. As a result, the nasal mucosa inadequately reacts to normal physiological stimuli.
Violation of the autonomic innervation of blood vessels at the level of microcirculatory-tion of the channel in the mucosa of the nose and in a topically related areas leads to profound changes of tissue homeostasis.
The development of the disease contributes significantly prolonged the uncontrolled use of vasoconstrictor nose drops.
In the development of allergic forms along with neurovegetative and endocrine disorders has a value of immunopathogenetic specific reaction between antigen and antibodies, which are distinguished biologically active swasta (histamine, acetylcholine, serotonin) that contribute to the clinical manifestations of the disease.
Pathogenesis (what is happening) during vasomotor Rhinitis:
Distinguish between allergic and neurovegetative form of vasomotor rhinitis.
- According to the severity of clinical signs of the disease was isolated hypersecretory, vasomotor and combined forms.
- For the duration of the disease: seasonal and permanent vasomotor rhinitis.
- Adrift: acute, subacute, chronic vasomotor rhinitis.
The symptoms of vasomotor Rhinitis:
The first signs of vasomotor rhinitis, usually occur in children older than 6-7 years.
Periodically there is a drastic violation of nasal breathing with itching in the nose, paroxysmal sneezing and profuse rhinorrhea, marked sweating, paresthesia, flushing of the face and conjunctiva of the eyelids, lacrimation. After the attack the color of normal mucosa, but sometimes on separate sites may remain swollen.
There is a definite cycle of the common cold, broken emergency irritants (cold, nervous tension).
In the interictal period persist symptoms associated with impaired nasal breathing due to hypertrophic rhinitis: hyposmia, fatigue, sleep disturbance, tachycardia, hearing loss, paroxysmal headache, caused by spasms of cerebral vessels.
Diagnosis of vasomotor Rhinitis:
To clarify the forms of vasomotor rhinitis are conducting a study of blood: detection of eosinophils in the blood and nasal mucus indicates an allergic form, which is often combined with bronchopulmonary pathology - asthmatic bronchitis or bronchial asthma.
Vasomotor rhinitis is virtually absent in newborns, infants and young children in connection with the underdevelopment of them cavernous tissue of the turbinates.
When rhinoscopy reveals the symptom of Vaahaka - speckled mucosa (bright erythematous areas interspersed with pale, pink and cyanotic, which are constantly changing places - "game of vasomotion"). Neurological examination of the child reveals organic or functional changes (diencephalic pathology, vegetative neurosis, encephalitis, arachnoiditis).
Treatment vasomotor Rhinitis:
Main therapeutic measures aimed at normalizing the functions of the Central and autonomic nervous systems, reducing the reflex excitability of the mucous membrane, reducing its blood supply.
Upper cervical sympathetic ganglia affect diadynamic-Kim current or conducting electrophoresis of a 1 solution of procaine on the collar area on Shcherbak. Use contact laser therapy pterygopalatine node. Spend intranasal blockade with novocaine, hydrocortisone, vipraksina, splenium or gistaglobina.
Justification of intranasal blockade are rich innervation of the mucosa of the turbinates and reflexive communication via the pterygopalatine ganglion with the throat and through blujdayuschie with the larynx. The nose is like a reflexogenic zone affects the entire body. When the intranasal WinUtilities blockade in the front ends of the turbinates is injected 0.5 to 1.0 ml of 0.5 solution of novocaine or other solution. At a deeper introduction (in the cavernous layer) solution goes directly into the bloodstream and does not give the expected effect. Spend phonophoresis corticosteroids, effect of helium-neon laser.
When the parasympathetic orientation autonomic tone good effect gives acupuncture and electroacupuncture.
Taking into account the daily dynamics of blood flow (high blood flow in the morning) use magnetic therapy (DC and AC magnetic field). The impact of low-energy laser and a magnetic field to the lesion improves microcirculation, increases the activity of enzymes and enzyme systems, enhances the oxidation of the substrate. Venous congestion in the mucous membrane of the nose means eliminate microcirculatory effects (glivenol, stugeron, caffeine, eskuzan), and to spend periods of exacerbation moderate dehydration in the mode of forced diuresis and apply nose drops (vasoconstrictor or contains atropine, which contributes to a significant decrease in the secretion of the mucous membrane of the nasal cavity).
Be sure to carry out the rehabilitation of the upper respiratory tract - treatment of diseases, keeping the congestion in the mucosa of the nasal cavity (adenotomy, submucosal resection of the nasal septum, treatment of sinusitis).
Pathogenetic therapy in the form of allergic vasomotor rhinitis involves specific desensitization.
With the active for vasomotor rhinitis with frequent exacerbations and the failure of conservative treatment perform palliative surgery:
- cryo - and laserodestruction, ultrasonic disintegration turbinates-
- mechanical destruction the rasp cavernous spaces through a vertical incision in the area of the anterior end of the inferior turbinate (submucosa azotemia)-
- intranasal selective denervation (cutting, electrocoagulation or laserodestruction posterior nasal branches of pterygopalatine node in the back ends of the lower and middle turbinates, the posterior division of the septum of the nose and in the transition region of the anterior wall of the sphenoid sinus at the bottom)-
- introduction crushed catgut through the stylet in the mucosa of the inferior turbinate to stimulate sclerotic process.
Under the sympathetic direction of autonomic tone blockage, alcoholism or surgical destruction of the upper sympathetic stellate ganglion, as well as surgery on the nerve of the pterygoid canal (Valiev nerve) with the intersection of its sympathetic component.
Patients with neurovegetative form of rhinitis need observation and treatment by a neurologist.