Symptoms of Chronic Rhinitis III

Symptoms

7. Temperature-related rhinitis For heat dissipation and retention on the body surface, hot air causes vasodilation within the nasal cavity, and cold air causes vasoconstriction. However, exposure of the feet to cold can induce nasal congestion. Therefore, in patients with nasal congestion, keeping the feet warm and opening windows frequently to allow cold, fresh air to enter may improve symptoms. However, if exposed to cold air for a long period of time, patients with allergic rhinitis may instead develop nasal congestion, so caution is needed.

8. Food-induced rhinitis Food-induced rhinitis is often also called gustatory rhinitis, and it causes a runny nose when eating food, especially hot or spicy foods or drinks. Sensory nerves in the palate trigger a cholinergic reflex, leading to symptoms. Treatment can help relieve symptoms by spraying 0.003% ipratropium bromide nasal spray 10 minutes before meals.

9. Rhinitis due to emotional causes Emotional factors such as anxiety, hostility, guilt, frustration, and resentment interfere with vasomotor control by the autonomic nervous system, causing nasal congestion and rhinorrhea and worsening existing nasal conditions.

In addition, some patients with rhinitis due to emotional causes may have nasal congestion caused by nasal congestion and migraine headaches, and in such patients, it is important to distinguish this from headaches caused by sinusitis. For treatment, it is advisable to eliminate factors that trigger stress or anxiety, and using medication to reduce congestion can be helpful.

10. Atrophic rhinitis Atrophic rhinitis is a chronic nasal disease accompanied by progressive atrophy of the nasal mucosa and the nasal turbinates, and it is characterized by the formation of thick crusts with viscous discharge and a persistent foul odor. This disease is not fatal, but it can become chronic, causing distress to patients and potentially creating obstacles in social life. In many cases, it is also accompanied by loss of smell, and in addition, headache, chronic sinusitis, or altered lifestyle behavior may appear.

Atrophic rhinitis occurs more often during puberty and is more common in women than in men.

Clinical symptoms of atrophic rhinitis include nasal congestion, dryness of the nose, a large amount of crusts, foul-smelling rhinorrhea, headache, or epistaxis, and loss of smell may also be present. Sometimes, without any other symptoms, only pharyngeal symptoms such as dryness of the throat, itching, cough, and voice changes are seen; this occurs due to dry pharyngitis, which often accompanies atrophic rhinitis, or due to breathing difficulty that occurs when formed crusts slip into the nasopharynx or oropharyngeal area.

11. Chronic hypertrophic rhinitis If proper treatment is not sufficiently provided to patients with chronic rhinitis, chronic inflammation persists and the nasal mucosa and nasal turbinates become irreversibly hypertrophied; this condition is called chronic hypertrophic rhinitis. Chronic hypertrophic rhinitis can be said to be the result of the inflammatory state of chronic rhinitis progressing continuously over a long period of time, regardless of the cause.

Medical treatments include oral decongestants, topical steroid sprays, and local steroid turbinate injections. Surgical treatments include procedures to improve nasal airflow such as turbinateplasty or turbinectomy, turbinate cauterization using electrocautery or medications such as trichloroacetic acid and silver nitrate, and mucosal surgery using lasers.

12. Rhinitis due to lack of airflow ① After total laryngectomy or after tracheostomy This is a representative case of rhinitis due to lack of airflow, in which the person can no longer breathe through the nose. It results from the loss of the periodic changes in temperature and humidity caused by nasal airflow, as well as the movement of the nasal ciliary mucus layer; the vascular layer loses its tone, the turbinates become moist, and purplish swelling is induced.

② Posterior choanal obstruction The condition of the nasal mucosa is similar to that of patients after total laryngectomy. In addition, because nasal mucus cannot be discharged through the posterior choanae, clear mucus accumulates within the nasal cavity.

③ Adenoidal rhinitis Interruption of nasal airflow due to adenoid hypertrophy, a type of lymphoid tissue in the nasopharynx, induces moisture and swelling of the turbinates and accumulation of clear serous rhinorrhea, regardless of the degree of adenoid inflammation. Because the symptoms are similar to those of allergic rhinitis, differential diagnosis is important.

13. Rhinitis due to systemic disease Nasal congestion can occur in superior vena cava syndrome, Oehler syndrome, cirrhosis, uremia, and others.

So far, I have explained the symptoms of chronic rhinitis III. In the next part, we will look at the diagnosis of chronic rhinitis.

Source: Korea Disease Control and Prevention Agency, National Health Information Portal