NAME – ANUJ UPADHYAY

GROUP- 23

COURSE- 4TH

Class 2
Task-46 years old man complains of difficulty in nasal breathing,
mucous discharge from the both sides. The patient is ill about 4 years.
He always use vasoconstrictor drops 4-5 times a day, but now it
doesn’t help.

Rhinoscopy: thick mucus discharge in both halves of the nose,

discharge flow down into the nasopharynx, mucosa of the lower nasal
turbinate has a rough, uneven surface, nasal passages are narrowed

X-Ray of the paranasal sinuses has no pathology.

1. Signs and symptoms of that disease in your patient

occlusive nasal, tinnitus, and ear occlusion flu and include headache,
dizziness, dry throat, sore throat. The patient is having difficulty in
nasal breathing , thick mucuos discharge from both halves of the nose,
flow of mucus into nasopharynx may be due to the usage of
vasoconstrictor , mucous membrane of inferior turbinate is rough and
uneven surface, more signs are seen in inferior turbinates due to
entirely of partial hypertrophication of anterior or posterior end of
inferior turbinate, nasal passage is narrow due to nasal congestion.
2.What is that disease? Give whole answer with the form (acute or
chronic, stage, degree if it's needed)

Hypertrophic rhinitis (HR) is a chronic disease in which there is an

increase (hypertrophy) of the mucous membrane and submucous layer
of the nasal cavity, periosteum, and in the most advanced stages, bone
tissue. In severe cases, tissue changes are irreversible. the case that
patient is ill for 4 years and always in a use of vasoconstrictor drops 4-5
times a day, but now it doesn’t help, these leads to rhinitis
medicamentosa( also known as rebound congestion) brought on by
extended use of topical decongestants. Patients often try increasing
both the dose and the frequency of nasal sprays this worsening the
condition. The swelling of the nasal passages caused by rebound
congestion may eventually result in permanent turbinate hypertrophy,
which may block nasal breathing.

3.Any other needed diagnostic that could be used for that case ?

Nonallergic rhinitis is diagnosed based on your symptoms and ruling

out other causes, especially allergies.

Anterior rhinoscopy can be done to see the enlargement of turbinates

Nasal endoscopy-this test involves looking at the inside of nasal

passage, done by using a thin , fibre optic viewing instrument called an
endoscope.

4.Treatment: medicamental (group of drug, example with doses and

duration), any procedures, any surgery if it's needed?
Conservative treatment of nasal inferior turbinate vasoconstrictor still
capable of narrowing, can be used the same way
with chronic simple rhinitis treatment can also be used
for treatment of inferior turbinate sclerotherapy laser, freezing or
microwave, radio frequency.

The use of over-the-counter (OTC) saline nasal sprays may help open
the nose without causing RM if the spray does not contain a
decongestant. Symptoms of congestion and runny nose can often be
treated with corticosteroid nasal sprays under the supervision of a
physician. For very severe cases, oral steroids or nasal surgery may be
necessary . Surgical treatment to delete hypertrophied tissues:Plastic of
turbinates or submucosal conchotomy.

other methods like

1. Linear cautherization
2. 2.submucosal diathermy
3. Partial of fully turbinectomy
4. Submucosal resection of turbinate bone

5. Possible complications
Mortality/Morbidity
Rhinitis medicamentosa can lead to chronic rhinosinusitis,
atrophic rhinitis, turbinate hyperplasia, psychological
dependence, and an abstinence syndrome upon intranasal
decongestant withdrawal that may include headaches, sleep
disturbances, restlessness, irritability, and anxiety. A case of
neonatal respiratory distress syndrome from topical
phenylephrine has been reported.