Rhinitis and sinusitis Symptoms, Diagnosis and Treatment

What are they :

The nostrils are the two cavities are separated by the nasal septum and fulfilling the functions of olfaction, because it houses the olfactory bulbs, voice modulation, since they act as a sounding board, and air flow regulation on inspiration, not only controlling your input pressure but also the humidity, temperature and purity (by trapping mucus and nasal cilia impurities in part contains air). These cavities are covered with a mucous membrane and when it becomes inflamed, for cause, that is, we speak of rhinitis. Rhinitis may be acute or chronic.

The sinuses are bony cavities communicated with the nostrils and covered by a mucosa similar to that covers them. At birth there are only two ethmoid, the fronts are in their twenties, the jaws when the wisdom teeth emerge and sphenoid are the later. Drain the middle meatus (the maxillary sinuses, frontal and anterior part of the ethmoid) and above (the sphenoid sinuses and the back of the ethmoid). When an inflammation of the mucosal tissue that lines the sinuses, usually by a blockage of the drainage pathways, sinusitis occurs.

How does it occur ?

Rhinitis is caused by an inflammation of the nasal mucosa. The most common cause is often nonspecific acute rhinitis, ie a secondary common cold symptoms, which is also called Coryza. The main cause is a viral infection, particularly that caused by a rhinovirus. The cold, high humidity and nasal obstruction are the main factors that predispose to acute nonspecific rhinitis. The infection is usually either direct air through droplets of saliva that are generated when speaking, calls Pflüger microdroplets.

Among the causes of chronic rhinitis can differentiate: 
seasonal allergic rhinitis, which is produced by different pollen allergy and also affects the conjunctival mucosa, pharyngeal and bronchial family in nature and occurs in cycles, especially in spring and summer. 
perennial allergic rhinitis, maintained throughout the year and caused by dust mites, pet dander and certain foods, a family history and reactivity to non-specific factors such as temperature, humidity and pollution. 
Rhinitis Intrinsic Perennial, without cause allergic, but with an implication of the types of white blood eosinophil. 
perennial rhinitis or vasomotor cholinergic without triggers or participation of eosinophils, the parasympathetic nervous system. 
hypertrophic rhinitis, chronic infections, if can evolve to give a state of atrophy of nasal mucosa, which is known as ozena. 
rhinitis sicca anterior, moderate atrophy of the anterior dominance of the nostrils.

There are diseases that can present rhinitis as one of its symptoms, such as tuberculosis, Wegener’s granulomatosis, syphilis, sarcoidosis, HIV infection or leprosy.

In adults, the maxillary sinuses are the ones most often affected, followed by the ethmoid and sphenoid fronts. In children only become infected ethmoid sinuses. When an obstruction of the sinus drain into the nasal passages, decreasing the oxygen pressure therein, which favors bacterial proliferation and the appearance of sinusitis. The cold, humidity and pollution reduce the movement of cilia, which predisposes to bacterial entry and playback on the breasts. Other disorders such as nasal polyps, nasal septum deviation or diseases such as diabetes can also favor the existence of sinusitis.

Sinusitis can be either acute or chronic, being the main cause of acute sinusitis bacterial infection, primarily by cocci and bacteria of type H. influenzae. In immunocompromised patients should be considered as aspergillosis fungal or mucormycosis as possible causes. Chronic sinusitis is usually unilateral maxilla, usually by altering a tooth that irritates the sinus floor.

Symptoms

The rhinitis is characterized by the presence of nasal congestion, rhinorrhea with, ie profuse mucus, which is usually generally thicker aqueous initially and if the process is lengthened or in the case of chronic rhinitis.Bursts of sneezing occur, especially in allergic rhinitis, nasal obstruction and itching in the nose and eyes, which are scarce in intrinsic rhinitis or vasomotor. There is also a decrease in the ability to smell (hyposmia) or total avoidance (anosmia). In intrinsic rhinitis nasal polyps are seen, which are rare in the other cases.

In previous dry rhinitis nasal dryness occurs in the anterior 2/3 of the nostril, which is also seen in cases of ozena. Both cases can cause nasal crusts may bleed and that in the case of the ozena can produce a foul odor, which is known as cacosmia, an odor that the patient does not perceive.

Acute sinusitis causes pain in the affected breast, nasal obstruction, facial swelling, anosmia, mucopurulent rhinorrhea and congestion of the mucosa. The pain varies with changes in posture, intensifying to increase pressure on the affected breast. Maxillary involvement occurs below the eye pain that increases with duck down. The ethmoid sinusitis causes pain between the eyes and on the root of the nasal septum. Frontal sinusitis causes pain that increases front pressing internal singing eyes and decreases throughout the day.The sphenoid sinusitis occurs isolated and never causes pain behind the eyes or in the center of the head.

Chronic sinusitis produces symptoms overlapping with runny nose and headache free.

Diagnosis

The diagnosis of rhinitis was based on clinical and physical examination. In allergic rhinitis, intrinsic be appreciated pale nasal mucosa, whereas observed vasomotor rhinitis is congested, red. In case of suspected allergic cause should be performed to determine battery test allergens. In the blood test will be appreciated elevated IgE in allergic rhinitis. In case of not having elevated IgE, eosinophils were found in the high intrinsic rhinitis, while their numbers will be normal or cholinergic vasomotor rhinitis.

Sinusitis is diagnosed based on the patient’s symptoms, physical examination and radiographs in different projections from which to judge the sinuses and see if they are occupied by material mutism.

Treatment

Treatment of rhinitis is usually symptomatic, with abundant moisture to thin mucous secretions, nasal decongestants. The treatment of choice for allergic rhinitis are antihistamines and avoiding exposure to allergens that cause. Intrinsic rhinitis usually responds well to topical corticosteroids while vasomotor only partially.

The dry rhinitis washes should be treated with saline to hydrate the nostrils and oily ointments. If there is a very marked hypertrophy or large polyps can turn to surgery.

Treatment of acute sinusitis is based on anti-inflammatory and antibiotic treatment for about 10 days, with amoxicillin with clavulanic acid treatment of choice. If a maxillary sinusitis that does not respond to treatment may raise breast surgical drainage.

Chronic sinusitis is treated with topical corticosteroids, budesonide or fluticasone mainly. If drug treatment is not enough, you can perform surgery, enlarging the drain holes of the affected sinuses.

Precautions

Avoid exposure to allergens, maintain proper hygiene of the nostrils, avoid smoky environments and contamination and hygienic precautions to be in contact with people with an infectious respiratory.