1 / 38

ACUTE AND CHRONIC RHINITIS

ACUTE AND CHRONIC RHINITIS. ACUTE RHINITIS. Acute Rhinitis can be – Viral Bacterial Irritative type. VIRAL RHINITIS. 1) Common cold (Coryza) Aetiology : Several viruses (adeno virus, picorna virus and its sub-groups sucha s rhinovirus, coxsackie, and ECHO)

dianef
Télécharger la présentation

ACUTE AND CHRONIC RHINITIS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. ACUTE AND CHRONIC RHINITIS

  2. ACUTE RHINITIS • Acute Rhinitis can be – • Viral • Bacterial • Irritative type

  3. VIRAL RHINITIS 1) Common cold (Coryza) • Aetiology : Several viruses (adeno virus, picorna virus and its sub-groups sucha s rhinovirus, coxsackie, and ECHO) • Clinical features : Nasal stuffness, rhnorrhoea, sneezing, low grade fever, secondary bacterial invasion may occur.

  4. Treatment : Bed rest, Plenty of fluids, Anthihistaminics, Nasal decongestants, Analgesics, Antibiotics, when secondary infection supervenes. Complications : • Sinusitis, pharyngitis, tonsillitis, bronchitis, pneumonia and otitis media.

  5. Influenzal rhinitis Rhinitis associated withexanthemas.

  6. BACTERIAL RHINITIS • Non specific infections • Diphtheritic rhinitis : • Primary • Secondary to faucial diphtheria • May occur in acute or chronic form • Treatment

  7. CHRONIC RHINITIS • Chronic non-specific inflammations of nose include : • Chronic simple rhinitis • Hypertrophic rhinitis • Atrophic rhinitis • Rhinitis sicca • Rhinitis caseosa.

  8. 1) CHRONIC SIMPLE RHINITIS • Aetiology : • Predisposing factors • Persistence of nasal infection • Chronic irritation • Nasal obstruction. • Vasomotor rhinitis • Endocrinal or metabolic factors

  9. Pathology : • Hyperaemia and oedema of mucous membrane • Hypertrophy of seromucinous glands • increase in goblet cells.

  10. Clinical features : • Nasal obstruction • Nasal discharge. • Headache • Swollen turbinates • Post-nasal discharge.

  11. Treatment : • Treat the predisposing factor. • Nasal irrigations with alkaline solution. • Nasal decongestants. • Antibiotics help to clear nasal infection.

  12. 2) HYPERTROPHIC RHINITIS • Characterized by thickening of mucosa, submucosa, seromucinous glands, periosteum and bone. Aetiology : • Recurrent nasal infections • Chronic sinusitis • Chronic irritation of nasal mucosa. • Vasomotor and allergic rhinitis

  13. Symptoms : • Nasal obstruction • Nasal discharge : thick and sticky. • Headache • Heaviness of head • Transient anosmia. Signs : • Hypertrophy of turbinates • Turbinal mucosa is thick, does not pit on pressure, little shrinkage with vasoconstrictor drugs due to underlying fibrosis. • Maximum changes in the inferior turbiante. • Mulberry appearance of inferior turbiante.

  14. Treatment : • Discover the cause and remove it. • Reduction in size of turbinates by • Liner cauterisation • Submucosal diathermy • Cryosurgeryof turbinates • Partial or total turbinectomy • Submucous resection of turbinates bone. • Lasers

  15. Compensatory hypertrophic rhinitis • In cases of marked deviation of septum to one side. • Roomier side of the nose shows hypertrophy of inferior and middle turbinates. • Reduction of turbinates may be required

  16. 3) ATROPHIC RHINITIS (OZAENA) • Chronic inflammation of nose characterized by atrophy of nasal mucosa and turbinate bones. Primary atrophic rhinitis : • Aetiology : Exact cause is not known, Various theories regarding its causation are: • Hereditary factors • Endocrinal disturbances

  17. Racial factors • Nutritional deficiency : Deficiency of vitamin A, D or iron • Infective : Klebsiella ozaenae, (Perez bacillus), diphtheroids, P.vulgaris, Esch. Coli, Staphylococci and Streptococci but they are all considered to be secondary invaders. • Autoimmune process : The body reacts by a destructive process to the antigens released from the nasal mucosa.

  18. Pathology : • Ciliated columnar epithelium is replaced by stratified squamous type. • Atrophy of seromucinous glands, venous sinusoids and nerve elements. • Obliterative endarteritis. • The bone of turbinates undergoes resorption. • Paranasal sinuses are small.

  19. Clinical features : • Commonly seen in females and starts around puberty. • Foul smell from the nose. • Marked anosmia (merciful anosmia) • Nasal obstruction • Epistaxis when the crusts are removed.

  20. Nasal cavity full of greenish or greyish black dry crusts. • Nasal cavities appear roomy. • Nasal mucosa appear pale. • Septal perforation and dermatitis of nasal vestibule. • Nose shows saddle deformity.

  21. Treatment : • Medical : • Nasal irrigation and removal of crusts- ( Sodium bicarbonate – 1 part , sodium biborate – 1 part, sodium chloride – 2 parts in 280 ml water) • 25% glucose in glycerine. – Inhibits the growth of proteolytic organisms which are responsible for foul smell.

  22. Local antibiotics – KemicetineTM antiozaena solution contains chloromycetin, oestradiol and vitamin D2. • Oestradiol spray – increase vascularity of nasal mucosa and regeneration of seromucinous glands. • Placental extract injected submucosally. • Systemic use of streptomycin – Effective against Klebsiella organisms. • Potassium iodide by mouth promotes and liquefies nasal secretion.

  23. Surgical • Young’s operation – Both the nostrils are closed completely just within the nasal vestibule by raising flaps. They are opened after 6 months or later. Modified young’s operation - Aims to partially close the nostrils.

  24. Surgical

  25. 2. Surgical : Narrowing the nasal cavities. Among the techniques followed, some are : • Submucosal injection to teflon paste. • Insertion of fat, cartilage, bone or teflon strips under the mucoperiosteum of the floor and lateral wall of nose and the mucoperichondrium of the septum. • Section and medial displacement of lateral wall of nose.

  26. SECONDARY ATROPHIC RHINITIS : • Specific infections like syphilis, lupus, leprosy and rhinoscleroma. • Longstanding purulent sinusitis, radiotherapy or nose or excessive surgical removal of turbinates. UNILATERAL ATROPHIC RHINITIS : • Extreme deviation of nasal septum. • Atrophic rhinitis on the wider side.

  27. RHINITIS SICCA • Crust-forming disease • Seen in patients who work in hot, dry and dusty surroundings. • Confined to the anterior third of nose. • The ciliated columnar epithelium undergoes squamous metaplasia. • Atrophy of seromucinous glands (Crusts, epistaxis, septal perforation). Treatment : • Bland ointment or an antibiotic and steroid. • Nasal douche.

  28. RHINITIS CASEOSA • Unilateral and mostly affecting males. • Nose is filled with offensive purulent discharge and cheesy material. • Sinus mucosa becomes granulomatous. Bony walls of sinus may be destroyed. Treatment : • Removal of debris and granulation tissue • Free drainage of the affected sinus.

  29. THANK YOU

More Related