Full-fledged nasal breathing is the key to optimal functioning of the systems of the whole organism. If it is disturbed, the brain ceases to receive a sufficient amount of the necessary oxygen. The air in the nose is also warmed, moisturized and purified.
With diseases of the respiratory system, a person's well-being worsens. When the nose is stuffed up, the patient breathes through the mouth. Efficiency decreases, memory weakens, irritability, headache, dizziness appear. Night sleep is disturbed.
Etiology
Turbine hypertrophy is the most common nasal pathology. The provoking factor is chronic hypertrophic rhinitis.
The epithelium of the nose is laced with many blood vessels. They form the cavernous (cavernous) plexus. The capillaries have a thin wall with muscle fibers that promote vasodilation and vasoconstriction. When their vasomotor (narrowing-expansion) activity is disturbed, swelling of the mucous membrane occurs. There is an overgrowth of the nasal mucosa. The nasal passages narrow, the air flow decreases, and shortness of breath develops.
Often, hypertrophy is combined with deformation of the nasal septum. This leads to a violation of full breathing. Sometimes pathology manifests itself in adolescence with changes in the hormonal background in the body.
There are two forms of the disease: diffuse (diffuse) and limited. The tissue of the lower part of the shells is usually affected. Less commonly, there are changes in the cavernous tissue (the middle part of the nasal cavity).
Symptoms
Thickening of the mucosa is accompanied by:
- Difficulty in nasal breathing. It improves somewhat after the use of vasoconstrictors, but for a short time.
- Mucous and purulent-mucous discharge.
- Discomfort in the nasopharynx (dry nose, mouth).
Periodic headache.
Periodic headache.The accumulated mucus causes a lump or foreign body sensation in the throat. Removal of secretions by blowing the nose is difficult. Sometimes the acuity of smell and taste decreases.
Secondary symptoms (consequences) of hypertrophy of the nasal mucosa:
- nasalness (talking "in the nose");
- hearing impairment (tubo-otitis) - develops as a result of impaired ventilation of the auditory tube;
- conjunctivitis, dacryocystitis (inflammation of the lacrimal sac) - is noted with changes in the anterior lower part of the shell, when the opening of the nasolacrimal canal is squeezed.
In some cases, the formation of polyps is observed with the growth of the corpora cavernosa. It is often necessary to treat such a pathology promptly.
Diagnostics
The main and most effective research method is endoscopy. It allows you to accurately determine the degree and location of the pathology.
With rhinodiagnostics, hyperplasia (thickening) of the nasal membrane of the lower part, less often of the middle one, is noted. The surface of the altered areas ranges from smooth to bumpy. The mucous membrane is reddened and somewhat cyanotic. The enlargement of the turbinates does not occur with the thickening of the bone base.
Another examination method is rhinopneumometry. With its help, the volume of air that passes through the nasal cavity for a specific time is determined. With hypertrophy, the volume of air entering the body is significantly reduced.
Therapy
Medication is often ineffective. The therapeutic effect of drugs is short-lived and poorly expressed. Prolonged use of vasoconstrictor drugs (adrenergic agonists) leads to overdrying of the mucous membrane. Discomfort appears - dryness, burning sensation in the nose. Addiction to drugs develops, the patient needs to increase the dosage and frequency of drug use. As a result, the therapeutic effect is reduced. Obstruction (blockage) of the nasal passages is difficult to eliminate.
The main types of surgical treatment:
- moxibustion (chemocaustics);
- conchotomy;
- lateroposition;
- UZDG.
The indication for one method or another is the degree of hypertrophic damage and respiratory disturbances. Manipulations take place under local or general anesthesia.
Cauterization is carried out using chemical compounds - 30-50% lapis (silver nitrous acid), chromic acid. Recently, it has been rarely used and only in the initial stages of hypertrophic degeneration.
The development of medicine has provided the emergence of new powerful optical systems. With the help of endoscopes, it is possible to accurately carry out surgical correction of hypertrophied nostrils, especially the poorly visible posterior parts of the nasal cavity. Thanks to a gentle surgical intervention, minimal tissue trauma can be achieved.
Regeneration of the mucous membrane occurs in the shortest possible time. Clinical studies indicate a rapid recovery of the ciliated epithelium while maintaining its functions. Accurate surgical correction avoids post-traumatic complications - tissue atrophy.
Osteoconchotomy is a careful removal of a part of the submucosal bone base of the inferior turbinate. Sometimes the aforementioned surgical interventions are combined with lateroposition — the displacement of the shells to the lateral wall of the nasal cavity.
Some experts recommend septoplasty (alignment of the nasal septum) when clearly needed. Important! In septoplasty, the surgeon must model a deviated septum from the same cartilaginous tissue.
During the operations, analgesics, antiallergic drugs and anticholinergics ("Promedol", "Atropine sulfate", "Diphenhydramine") are used. A 1% solution of novocaine, 1-2% lidocaine, 0.5% ultracaine or trimecaine is used as a local anesthetic. Surgical treatment takes place in a hospital setting.
On an outpatient basis, USG is carried out - ultrasonic disintegration of the lower parts of the turbinates. This method of treatment is based on the restoration of the vasomotor capacity of the blood vessels. With the help of an ultrasonic waveguide - apparatus "Lora-Don-3", old sclerosed vessels are destroyed, which the body replaces with new ones. Their original ability to expand and contract is restored. With a successful operation, nasal breathing is normalized after 3-4 days.
In the postoperative period, decongestants (decongestants) - "Otrivin", "Nazivin" are used to reduce the swelling of the mucous membrane. They also reduce the likelihood of complications.
In addition, rehabilitation includes the use of antibacterial and antihistamines (antiallergic) drugs (Tsetrin, Zodak, Fenistil, Loratadin, Zirtek, etc.), daily tamponing of the nostrils for 3-5 days. It is recommended to rinse the nose with nasal sprays based on sea or mineral water for 15-20 days. They use "Aqua Maris", "Dolphin", "Aqualor", "Rhinorin", "Marimer".
Correct drug treatment and successful surgery prevent perforation (opening) of the nasal septum. If its curvature is the cause of the development of hypertrophy, then the pathology that has appeared is reversible.
