chronic rhinitis

Question 1

What are the types of chronic nonspecific inflammations of the nose?

Answer 1

1. Chronic simple rhinitis 2. Hypertrophic rhinitis 3. Atrophic rhinitis 4. Rhinitis sicca 5. Rhinitis caseosa

Question 2

What factors predispose to chronic simple rhinitis?

Answer 2

1. Nasal infection (sinusitis, tonsillitis, adenoids) 2. Chronic irritation (dust, smoke) 3. Nasal obstruction (deviated septum, synéchia) 4. Vasomotor rhinitis 5. Endocrinal/metabolic factors (e.g., hypothyroidism, excessive carbs, lack of exercise)

Question 3

What are the clinical features of chronic simple rhinitis?

Answer 3

1. Nasal obstruction (worse when lying) 2. Nasal discharge (mucoid/mucopurulent, postnasal drip) 3. Headache (swollen turbinates) 4. Swollen turbinates (dull red, pit on pressure) 5. Postnasal discharge

Question 4

What is the treatment for chronic simple rhinitis?

Answer 4

1. Treat underlying causes 2. Nasal irrigations 3. Nasal decongestants (short-term) 4. Antibiotics

Question 5

What defines hypertrophic rhinitis?

Answer 5

Thickening of mucosa, submucosa, seromucinous glands, and bone, especially on turbinates.

Question 6

What are the symptoms of hypertrophic rhinitis?

Answer 6

Nasal obstruction, thick and sticky discharge, headache, possible anosmia

Question 7

How is hypertrophic rhinitis treated?

Answer 7

1. Remove cause 2. Reduction of turbinates (methods: linear cauterization, submucosal diathermy, cryosurgery, turbinectomy, submucous resection, laser treatment)

Question 8

What is atrophic rhinitis characterized by?

Answer 8

Chronic nasal inflammation with atrophy of mucosa and turbinate bones, leading to roomy nasal cavities and foul-smelling crusts (grey,green crusts)

Question 9

What are the types of atrophic rhinitis?

Answer 9

1. Primary (HERNIA factors) 2. Secondary (due to infections, radiotherapy, or excessive surgical removal)

Question 10

What does the HERNIA mnemonic stand for in primary atrophic rhinitis?

Answer 10

1. Hereditary 2. Endocrinal disturbance 3. Racial factors 4. Nutritional deficiency 5. Infective 6. Autoimmune process

Question 11

What is the treatment for primary atrophic rhinitis?

Answer 11

1. Nasal irrigation 2. Glucose in glycerine 3. Local antibiotics 4. Oestradiol spray 5. Placental extract 6. Systemic streptomycin 7. Potassium iodide

Question 12

What is the treatment for primary atrophic rhinitis and the function of each step?

Answer 12

Nasal Irrigation: Use warm saline or alkaline solutions to loosen and remove crusts, and reduce thick discharge.
Glucose in Glycerine: Paint nasal cavity to inhibit growth of odor-causing bacteria.
Local Antibiotics: Spray or paint the nose to eliminate secondary infections.
Oestradiol Spray: Increases vascularity and aids in the regeneration of seromucinous glands.
Placental Extract: Injected submucosally to promote healing and reduce crusting.
Systemic Streptomycin: Administered to target Klebsiella organisms, reducing crusting and odor.
Potassium Iodide: Oral administration to liquefy nasal secretions and reduce crust formation.

Question 13

What is rhinitis sicca?

Answer 13

Crust-forming disease from working in hot, dry, dusty environments, affecting the anterior nasal septum.

Question 14

What is the treatment for rhinitis sicca?

Answer 14

Correct occupational environment, apply bland ointments or antibiotic/steroid ointments, avoid nose pricking.

Question 15

What characterizes rhinitis caseosa?

Answer 15

Offensive purulent discharge and cheesy material, usually unilateral.

Question 16

How is rhinitis caseosa treated?

Answer 16

Remove debris, granulation tissue, and ensure free sinus drainage.