Causes and risk factors
Rhinitis is usually caused by virus – rhinovirus, influenza virus, or adenovirus. Secondary infection may be caused by bacteria like streptococcus or staphylococcus. Chronic hypertrophic rhinitis is caused due to recurrent attacks of acute rhinitis. Overuse of nasal drops or topical decongestants is a major causative factor for this disease. Predisposing factors include infections like sinusitis, tonsillitis. Other factors such as vasomotor rhinitis, DNS, nasal polyps, atmospheric pollution, general debility, diseases like hypothyroidism lead to the disease. Additional risk factors include smoking and alcohol drinking.
Clinical presentation
In chronic hypertrophic rhinitis there is hypertrophy of nasal turbinates. This causes nasal obstruction. It is more pronounced at night. Thick, viscid nasal discharge is present called as rhinorrhea. Loss of sense of smell may occur [anosmia]. There is congestion of nasal mucosa. There is continuous nasal itching and sneezing. Postnasal drip and nasal blockage is prominent. Rhinoscopy may reveal mulberry like posterior ends of inferior turbinates. They are soft in consistency.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. CBC is advised. Rhinoscopy is recommended. Imaging studies such as nasal endoscopy, CT, MRI may be useful for further evaluation.
Treatment
Nasal decongestants give temporary relief. Surgical treatment is needed for hypertrophic turbinates such as electrocautery, submucosal diathermy. Cryosurgery may be useful. Laser and radiofrequency ablation may be utilized. Further treatment consists of partial turbinectomy.
Other Modes of treatment
The other modes of treatment can also be effective in treating chronic hypertrophic rhinitis. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating chronic hypertrophic rhinitis.
