Inferior or middle turbinate hypertrophy

Introduction Turbinate hypertrophy refers to the long-term inflammation of the turbinate caused by edema of the turbinate mucosa, leading to nasal obstruction. Specific parts of the turbinate hypertrophy should be identified. The nasal congestion is heavier, mostly persistent, often breathing, and the sense of smell is reduced. The nose is thick, mostly mucous or purulent. Due to the snot of the nose, irritation of the throat causes coughing and phlegm. When the enlarged middle turbinate presses the nasal septum, it can cause the anterior ethmoid nerve of the trigeminal nerve branch to be compressed or inflamed, and occasional episode of frontal pain, and radiate to the bridge of the nose and eyelids, called pre-screening neuralgia, also known as Pre-screen nerve syndrome.

Cause

Generally developed from chronic simple rhinitis. Mucosal epithelial cilia shedding, becoming a stratified cubic epithelium, submucosal edema followed by fibrous tissue hyperplasia and mucosal hypertrophy, for a long time, may be mulberry-like or polypoid changes, periosteal and bone tissue hyperplasia, turbinate bone can also be present Hypertrophy changes.

an examination

Related inspection

Nasopharyngeal MRI

(1) The nasal congestion is heavier, mostly persistent, often breathing, and the sense of smell is reduced.

(B) the nose is thick, mostly mucinous or purulent. Due to the snot of the nose, irritation of the throat causes coughing and phlegm.

(3) When the hypertrophic middle turbinate presses the nasal septum, it may cause the anterior ethmoid nerve of the trigeminal nerve branch to be compressed or inflamed, and occasional episode of frontal pain, and radiate to the bridge of the nose and eyelid, called pre-screening neuralgia. , also known as pre-screen nerve syndrome.

Differential diagnosis

The inferior turbinate or middle turbinate hypertrophy needs to be identified as follows.

(1) Nasal septum or turbinate hypertrophy

The patient's nasal congestion often exists throughout the year, mostly unilateral, no nasal itching and obvious seasonal tendency. Nasal speculum examination can confirm the diagnosis.

(2) drug rhinitis (rhinitis medicamentosa)

Common drugs that can cause increased nasal congestion and secretions, Fafuping and its various preparations, ganglion blockers, oral contraceptives, etc. In recent years, due to the amount of vasoconstrictor used in nasal congestion, or too strong (such as the nose of the nose), it is often caused by the rebound of the vasodilator to cause drug-induced rhinitis, which needs to be carefully distinguished.

(three) symptomatic nasal congestion

In addition to the common cold in the clinic, it is easy to ignore the premature nasal obstruction, nasal obstruction during pregnancy and nasal congestion during hypothyroidism.

(four) vasomotor rhinitis (vasomoto rhinitis)

It is an unexplained "onset" rhinitis. The nasal symptoms of patients often occur suddenly due to changes in temperature, eating spicy or inhaling irritating odor, and are easily confused with this disease. The main points of identification are lack of sneezing, itchy nose, sore throat, etc. Symptoms, antihistamine and desensitization therapy are ineffective.

(5) Chronic rhinitis

Also known as eosinophilic perennial nonalergic rhinitis, its nasal secretions also have a large number of eosinophils, often symptoms all year round, but allergens are often not found, so the cause is unknown. Such rhinitis patients are often associated with nasal polyps, and some are associated with infectious asthma (thus constitutes "aspirin allergy - asthma - rhinitis and nasal polyps triad"), which is different from allergies is nasal congestion and turbinate The swelling is obvious, the secretion is mucus-like, the anti-histamine effect is poor, and the sodium cromolyn and desensitization treatment are ineffective.

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