Nasal mucosa and turbinate atrophy

Introduction Nasal mucosa and turbinate atrophy are one of the common symptoms of atrophic rhinitis. Atrophic rhinitis is a chronic disease of the nasal mucosa and bone atrophy, accompanied by strange smells, also known as stinky nose. There are more young women. The main pathological change is occlusive endocarditis, which causes atrophy of the nasal mucosa gland, periosteum and bone. Mucosal and bone vessels gradually develop occlusive endarteritis and spongy venous plexus, connective tissue hyperplasia of the vessel wall, narrowing or occlusion of the lumen, poor blood circulation, leading to mucosal, glandular, periosteal and bone atrophy, fiber The pseudo-stratified ciliated columnar epithelium of the mucosa gradually transforms into a stratified squamous epithelium.

Cause

Early pathological mucosa showed only chronic inflammation changes, which in turn progressed to progressive atrophy. Mucosal and bone vessels gradually develop occlusive endarteritis and spongy venous plexus, connective tissue hyperplasia of the vessel wall, narrowing or occlusion of the lumen, poor blood circulation, leading to mucosal, glandular, periosteal and bone atrophy, fiber The pseudo-stratified ciliated columnar epithelium of the mucosa gradually transforms into a stratified squamous epithelium. Even pterygopalatine ganglia can also undergo fibrosis.

an examination

Related inspection

Nasal endoscopy nasopharynx MRI

Basic inspection:

1. Front nose examination.

2. X-ray nasal photos have clear sinus infection.

Further examination:

1. Nasal secretion smear to detect pathogenic bacteria.

2. Nasal secretions bacterial culture + drug sensitivity.

3. If necessary, virus inspection requires special cultivation, separation and identification.

Differential diagnosis

Dry and itchy of the nasal mucosa: Capillaries are prone to rupture and bleeding, which is a symptom of dry rhinitis. Chronic rhinitis sicca is generally thought to be caused by external physical or chemical stimuli, such as mechanical stimulation of long-term dust, effects of air overheating and excessive drying. The disease is a common occupational chronic rhinitis. It is characterized by dryness and discomfort in the nasal mucosa, less secretion, and the patient generally does not have runny nose. Because of the itching sensation in the nose, patients often dig their noses and cause nasal bleeding.

Nasal mucosal ulcers: Nodular infiltration under the nasal mucosa, followed by erosion, can lead to scarring adhesions. In the late stage, there was atrophy due to dryness and scarring of the nasal cavity. The anterior nares are narrow. The nasal mucosa is pale and thick, and the secretions increase. There may be purulent sputum and nosebleeds, but the patient may not feel pain.

Swelling of the nasal mucosa: The stability of the environment inside the nasal mucosa, in addition to relying on neuromodulation, also undergoes regulation of endocrine hormones. The nasal mucosa is rich in various components of the vascular bed and mucosal immunity. At the level of the neuroendocrine immune network, changes in the levels of endocrine hormones can affect the nasal mucosa through blood circulation. In patients with clinically common female rhinitis, the symptoms are significantly aggravated in the premenstrual period, and the symptoms are alleviated or disappeared after the menstrual period. Menstrual and gestational women have hypertrophy of the nasal mucosa and dilated glands. The result of the above changes can produce respiratory mucosal immune or non-immune inflammation leading to the formation of high reactivity of the nasal mucosa, thereby causing rhinitis symptoms such as nasal congestion, runny nose, itchy nose, and sneezing. In addition, prostaglandins can inhibit the production of antibodies by B cells and inhibit the phagocytic function of macrophages. At the same time, prostaglandins as an inflammatory factor can cause vasodilatation in the onset of rhinitis and aggravate the degree of inflammatory response. In the nasal mucosa of patients with allergic rhinitis, the prostaglandin receptors also increase, resulting in dilated blood vessels in the nasal mucosa, nasal congestion and corresponding nasal congestion and hypersensitivity.

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