For the diagnosis of chronic rhinitis and determine its causes perform endoscopy — rhinoscopy, if there is pus — X-ray or CT scan of the paranasal sinuses. Also conduct laboratory diagnosis: general and biochemical blood tests, urinalysis, suspected allergic nature of the disease — definition of immunoglobulins in the CROI and intradermal allergy tests. If you plan to infection, performed bacteriological analysis (seeding) discharge from the nose to identify the pathogen and to evaluate its sensitivity to antibiotics. You may need histological examination of the nasal mucosa.
How to Treat chronic running nose
For treatment of chronic catarrhal rhinitis applied topically as drops in nose collargol and Protargolum which have astringent (decrease mucus production) and antibaktrialnym action. For the treatment of exacerbations of chronic catarrhal rhinitis caused by infection, antibiotics are used topically. This ointment may be, for example, 2% and 2% sulfanilamide salicylic ointment Baktroban (active ingredient mupirocin). As well as nasal sprays containing antibiotics, for example, and Izofra Polydex (except antibiotics it includes a protivovspalitelnym glucocorticoid action and the alpha-agonists with a vasoconstrictor). Assigns a specific drug ENT physician in view of the sensitivity of pathogenic micro-organisms, which is determined by performing bacteriological analysis (crop discharge from the nose).
Treatment chronic atrophic rhinitis — Most symptomatic. Of great importance is constant hydration mucosa of the nasal cavity with salt solutions, such as solutions of sea salt. Moisturize mucosa can be carried out by dropping drops, irrigation sprays, and with the help of special irrigators. Frequently eases suffering lubrication atrophic rhinitis nasal mucosa 5% aqueous glycerin iodine drops instillation and oil-based (peach, olive, etc.). In the presence of pathogenic microorganisms administered antibacterial treatment depending on the kinds of microorganisms during certain bacteriological analysis.
Chronic hypertrophic rhinitis in the early stages sometimes try to treat the introduction of the nasal cavity suspension of hydrocortisone. But, as a rule, surgical treatment can not be avoided. The operation is to remove unnecessary overgrown tissue nasal mucosa. With a little hypertrophy spend most sparing surgery. This could be burning (lapis, trichloroacetic acid or chromic acid), or destruction of the mucous too overgrown by electrocoagulation or radiowave surgery, cryotherapy, ultrasound or laser. In some cases, with little hypertrophy of submucosal vasotomy perform, which is the detachment of the mucous membrane and the destruction of the vascular plexus. When scarring after vasotomy is a reduction of the nasal cavities and increase the lumen of the nasal passages. In severe hypertrophy perform a partial resection of the posterior ends of hypertrophied inferior turbinates (gentle turbinotomy), submucosal removal of the edge of the inferior turbinate (ostekonhotomiya) or podlamyvanie nasal shells at the base and move aside her aside to expand the nasal passages (laterokonhpeksiya).
For treatment of chronic vasomotor rhinitis use hormonal medications (corticosteroids) are applied as sprays or injections under the mucous membrane of the nasal turbinates. They relieve swelling and chronic inflammation, but do not eliminate the cause of the disease. Surgical methods of treatment of rhinitis are vazomotrnogo vasotomy submucosa, the destruction of the submucosal blood vessels electro-coagulation or radio wave, laser or photodestruction. Recently, for these purposes are used high-intensity focused ultrasound.
Nasal allergy— This is an indication for use of systemic anti-allergic agents. If not severe, often children can also use nasal sprays containing derivatives of sodium cromoglycate (e.g. Kromogeksal or Kromoglin) or by a plant-based cellulose, forming a protective film on the nasal mucosa (e.g., Nazaval). These preparations can be used for several months or even round, but they are preferably prophylactic effect. In severe disease drugs of choice are intranasal corticosteroids. Such formulations are produced in the form of sprays, their dosage form allows for the correct dosage is almost completely avoid systemic exposure that allows them to be used safely for a long time. Nose drops with vasoconstrictor not have any pronounced positive effect of the symptoms of allergic rhinitis, on the contrary, their prolonged use may lead to a worsening of the situation and even to the development of medical rhinitis. If a medication is not able to succeed, it is advisable to consult with an allergist on the application of allergen-specific immunotherapy (SIT). This type of treatment can only be carried out allergist in a specialized hospital or allergist's office. Treatment is administered as a rule injection, gradually increasing doses of allergens. The purpose is to develop resistance to the allergens causing the reaction. Of great importance in the treatment of patients with allergic rhinitis is the elimination of precipitating factors (dust, pets, food).