scholarly journals Difficult nasal breathing in the ENT-practice: how to help?

2020 ◽  
Vol 19 (2) ◽  
pp. 107-115
Author(s):  
S. V. Ryazantsev ◽  
◽  
S. S. Pavlova ◽  

The article discusses the most common causes of diseases that cause difficulty in nasal breathing. According to the analysis of medical documentation, diseases accompanied by nasal obstruction and rhinorrhea are the most common human diseases. The priority role in the development of the clinical symptoms of rhinitis is played by the release of inflammatory mediators – histamine and bradykinin. Histamine in rhinitis mediates a cascade of pathological reactions, as a result of which local vasodilation develops, accompanied by swelling of the mucous membranes; nasal congestion; increased permeability of the vascular wall; exudation of blood plasma; irritation of nerve endings; triggering reflex mechanisms by stimulating trigeminal histamine receptors. Peculiarities of the course of intermittent and persistent forms of allergic rhinitis, the pathogenesis of allergic inflammation are considered. To reliably eliminate abundant rhinorrhea, combined with nasal congestion, the authors recommend the use of a combined nasal spray, which contains phenylephrine and cetirizine (Phenylephrine + Cetirizine). Based on the analysis of literature data, the effectiveness and safety of the use of the topical form of cetirizine are substantiated. Aspects of the clinical use of the combination of phenylephrine and cetirizine in inflammatory and allergic diseases of the nasal cavity and paranasal sinuses, in the pathogenesis of which the key role is played by swelling of the mucous membrane of the nasal cavity, are examined. It is proved that the new combined nasal spray of domestic production is an effective and safe method for treating patients with manifestations of various forms of rhinitis and nasal obstruction.

2012 ◽  
Vol 9 (5) ◽  
pp. 55-59
Author(s):  
A A Tsyvkina ◽  
L V Luss ◽  
S V Tsarev ◽  
N V Shartanova

Background. To study of efficacy, tolerability and safety of nasal spray Prevalin in the treatment of allergic rhinitis patients. Methods. 30 patients with allergic rhinitis in the age of18 till 45 years were observed. Prevalin was given as one insufflation into each nasal cavity 3 times a day for 21 days. Results of treatment were assessed by the dynamics of clinical symptoms and the results of functional methods . Results. The positive clinical effect was observed in 22 patients (73,3%), using Prevalin. Clinical effect was characterized by the restoration of nasal breathing, reduce swelling of the nasal mucosa. We did not establish a good result of treatment in 8 patients. Conclusion. The study demonstrated clinical efficacy and safety of spray Prevalin.


2019 ◽  
pp. 60-65 ◽  
Author(s):  
S. V. Morozova ◽  
L. A. Toporkova

One of the main functions of the nose is respiratory and olfactory. Difficulty in nasal breathing, nasal congestion, nasal discharge can complicate the respiratory and olfactory functions of the nose or make them impossible. Most often the cause is swelling of the mucous. Nasal obstruction and rhinorrhea are the most common symptoms in diseases of the nasal cavity and paranasal sinuses. Of great importance is the use of local vasoconstrictors to eliminate swelling in the nasal cavity and prevent complications associated with auditory tube dysfunction. It is proved that the use of nasal decongestants helps to reduce swelling in the nasal cavity and in the osteomeatal complex. Otrivin Moisturizing formula, Otrivin Menthol, Otrivin Complex and Otrivin Sea are effective and well tolerated means to eliminate swelling in the nasal cavity and reduce nasal discharge and rehabilitation of olfactory function.


Author(s):  
M.A. Ryabova ◽  
◽  
L.V. Georgieva ◽  

The prevalence of allergic diseases is increasing: according to recent data, about 20% of the worlds' population suffers from allergic rhinitis. About 30% of the reproductive age women are known to suffer from allergic rhinitis, and in a third of cases, symptoms of allergic rhinitis increase during pregnancy. Allergic inflammation is the result of contact with a causative allergen and elimination of causative allergens is not always possible. The creation of a protective barrier preventing the adhesion of allergens on the surface of the nasal mucosa reduces the penetration of allergens and helps control allergic rhinitis. Aqua Maris® Nasal Spray Ectoin is a completely natural remedy that creates a physical barrier (“barrier”) for attaching allergens to the nasal mucosa and prevents the development of allergic rhinitis. Aqua Maris® Ectoin can be used for allergic rhinitis treatment in pregnant and nursing women. Non-comparative open-label trial investigating the efficacy and safety of the Aqua Maris® Nasal Spray Ectoin was carried out from September to June 2019 at the Center of early diagnosis of allergic diseases in women of childbearing age Pavlov First Saint Petersburg State Medical University. The study included 45 pregnant women with allergic rhinitis. Clinical efficacy was evaluated by the severity of clinical symptoms and rhinoscopic data of patients in dynamics during treatment. As a result of the use of Aqua-Maris Ectoin in pregnant women, a significant reduction in complaints on the 10th day of therapy and a decrease in inflammatory phenomena in the nasal cavity were observed. In addition, a significantly significant decrease in secretory nasal IgE was noted. This indicates the effectiveness of the Aqua Maris® Nasal Spray Ectoin in the treatment of allergic rhinitis in pregnant women. Adverse events associated with the use of Ectoin Aqua Maris® Nasal Spray in pregnant women were not detected. Aqua Maris® Nasal Spray Ectoin can be used for effective and safe treatment of allergic rhinitis in pregnant women.


2020 ◽  
pp. 101-106
Author(s):  
V. M. Svistushkin ◽  
G. N. Nikiforova ◽  
P. S. Artamonova ◽  
E. A. Shevchik

The incidence of allergic rhinitis has been increasing rapidly worldwide in recent years. About 40% of the world’s population suffer from allergic inflammation of the nasal mucous membrane. Clinical manifestations of allergic rhinitis are absence or difficulty of nasal breathing, itching, sneezing, nasal congestion and rhinorrhoea, as well as swelling of the face, the presence of dermatitis in the region of the nasal wings, general malaise, smell disturbance. Manifestations of allergies by ENT organs in most cases do not pose a threat to life, but they can cause the development of other pathological processes, bad sleep, irritability, decreased efficiency, mood swings, which, in turn, adversely affects human health and reduces the quality of life. The pathogenesis of allergic rhinitis is based on an immediate hypersensitivity. According to the modern classification, depending on the nature of the course of the disease it is common to identify intermittent and persistent forms.At present, the drugs of choice in the treatment of patients with allergic rhinitis are intranasal glucocorticosteroids. However, the presence of a concomitant pathology of the nasal cavity in the patient, such as deviated septum, not only significantly impairs the course of nasal inflammatory process, but also creates obstacles to adequate delivery of topical drugs to all parts of the nasal cavity, which, in turn, reduces their effectiveness.For patients suffering from allergic rhinitis in combination with other pathology of the nasal cavity, combined oral medications may be a good alternative to intranasal sprays. Certain interest for doctors is caused by the appearance of a combined antihistamine drug on the Russian market, which includes a blocker of leukotrienes and H1-histamine receptors of the second generation – montelukast and levocetirizine. The drug can be used both in adults and children from 15 years old for treatment of intermittent and persistent forms of allergic rhinitis.Timely and properly performed therapy of allergic rhinitis allows to eliminate symptoms of the disease and prevent the development of complications.


Author(s):  
Venkatesha B. K. ◽  
Ravi Shekhar

<p class="abstract"><strong>Background:</strong> Adenoid hypertrophy (AH) is a common cause of upper airway obstruction and obstructive sleep apnea syndrome (OSAS) in children having major impact on child’s growth and development. Symptoms like nasal congestion, mouth breathing, nasal discharge, snoring, day time sleepiness, hyponasal voice, ear popping, and craniofacial abnormalities are observed. Adenoidectomy is considered the treatment of choice for symptomatic children. Co-existing medical illnesses and choice of surgical treatment is governed by the paediatricians and apprehensive parents. Need for conservative treatments in alleviating symptoms have been tried. Topical, intranasal administered, steroid preparations have been proven effective in the literature.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 35 symptomatic children (3-12 years) with adenoid hypertrophy were included. Each of the symptoms was scored from 0 (absent) to 4 (severe) over Visual Analogue Scale (VAS). Nasal obstruction index was calculated. Results of mometasone furoate nasal spray 100 microgram/day used once daily at the interval of 8 weeks and 12 weeks were analysed using statistical tests.  </p><p class="abstract"><strong>Results:</strong> A statistically significant reduction in nasal obstruction index and other symptoms were noted at the end of third month follow up.</p><p class="abstract"><strong>Conclusions:</strong> Mometasone furoate nasal spray caused improvements in outcomes of nasal obstruction, snoring, total nasal symptoms, ear symptoms and overall quality of life.</p>


2018 ◽  
Vol 01 (03) ◽  
pp. 219-222
Author(s):  
Yuting Zhang ◽  
Yushan Liu ◽  
Lihong Meng ◽  
Huan Dong ◽  
Xiaofeng Gu ◽  
...  

Objective: To observe the clinical symptoms after haze exposure and analyze the influences on the respiratory tract. Methods: We conduct prospective study by designing questionnaires about respiratory reaction after haze exposure. We distribute, and collect the questionnaires from 301 subjects, and use statistical software to analyze it. Result and Conclusion: (1) Exposure to haze can lead to a series of respiratory and systemic symptoms. The most common symptoms are cough, little sputum, sneezing and running nose, nasal cavity dryness, nasal congestion, dry throat, dry eyes, itchy eyes. (2) The manifestation frequency of most symptoms in population is positively correlated with the haze concentration. (3) Haze irritates the respiratory tract and causes haze-related cough and respiratory allergy symptoms.


2021 ◽  
pp. 120-124
Author(s):  
K. A. Nikitin ◽  
S. V. Baranskaya

Nasal congestion is one of the most common symptoms of common colds and rhinitis, due to an inflammatory reaction, vasodilation, increased nasal blood flow and vascular permeability. Nasal obstruction is often a multifactorial problem, in addition to infectious causes, it can be caused by a combination of anatomical aberrations, swelling of the nasal mucosa and enlargement of the turbinates. Anatomical and structural problems, such as nasal septum deviation and nasal valve collapse, are usually treated surgically. Drug therapy of nasal obstruction is aimed at reducing edema and inflammation of the nasal mucosa. Pharmacotherapy of nasal obstruction is aimed at reducing inflammation and/or swelling of the mucous membrane. Decongestants are widely prescribed to relieve symptoms. The drugs used have different mechanisms of action and include systemic and topical drugs. This article discusses decongestants as a treatment for nasal obstruction. When applied topically, the drugs of this group act directly on the α2 and α1-adrenergic receptors of the nasal cavity, causing vasoconstriction, a decrease in the volume of the nasal conch, an increase in nasal patency, and relieving the symptoms of obstruction. The existing risk of developing side effects, both systemic and local, is reduced with atopic exposure and proper dosing of the drug used. Preferably, the use of drugs with low bioavailability. The suppression of the ciliated epithelium can be caused not only by the pathological process, but also by the composition of drugs. The value is given to the acidity of the buffer system. The optimal pH value of intranasal agents is about 6 (neutral range). The combination with anticholinesterase substances reduces the production of pathological discharge. The use of multi-component medicines allows you to restore nasal breathing and suppress excessive nasal secretion. One of the effective and safe drugs of topical action is Xylometazoline, as a monocomponent agent or in combination with ipratropium bromide.


Author(s):  
Rainer K. Weber ◽  
Evangelos I. Giotakis ◽  
Tanja Hildenbrand ◽  
Werner Heppt

AbstractWe describe the (anteromedial) partial maxillectomy technique which can be used to address impaired nasal breathing in cases of significant protrusion of the frontal process of the maxilla into the nasal cavity, narrowing the nasal pathway. It fits to nasal physiology avoiding mucosal resection. It can be combined with surgery of the inferior turbinate. The described technique can be used in all forms of rhinoplasty.


2021 ◽  
pp. 72-77
Author(s):  
S. A. Karpishchenko ◽  
O. Е. Vereshchagina ◽  
E. O. Teplova

Introduction. Clinical manifestations of rhinitis have a negative impact not only on the physical, social, and psychological health of children, but also on their parents, especially in families with a first child. Nasal congestion, nasal breathing difficulty cause problems with sleep and feeding.Aim of the study. To estimate the occurrence of rhinitis in children under two years old in the outpatient practice of otorhinolar-yngologists, to consider features of the course and differential diagnostics of various rhinitis types, to evaluate the effectiveness of nasal irrigation-elimination therapy in the treatment of acute rhinitis symptoms.Materials and Methods. Between September 2020 and July 2021, 220 patients between 0 to 18 years were managed: preschool-aged patients comprised 120 patients (54.5%), of whom 27 patients under two years old had symptoms of rhinitis, including those with symptoms lasting more than two weeks.Results. Among the patients referred to us, infectious rhinitis was diagnosed in the majority of cases - in 18 patients (66,7%), which can be explained not only by the timing of the study but also by the highest prevalence of this pathology among the diseases of the nasal cavity. Allergic and non-allergic rhinitis occurred in only 4 (14.8%) and 5 (18.5%) persons, respectively. Symptomatic irrigation therapy with saline solutions is just as necessary for young children as it is for older children and adults. Some difficulties in nasal cavity care during rhinitis are the anatomical narrowness of the nasal passages and lack of blowing skills in young children. In these situations, preference should be given to gentle, non-traumatic, gentle aspiration with prior irrigation of the nasal cavity with an isotonic saline solution. When a nasal aspirator was used, there was a decrease in the duration of nasal discharge during the illness and a reduction in the duration of the disease.Conclusion. Rhinitis in young children is a common but underestimated problem. Clinical manifestations are more often associated with typical symptoms: nasal congestion, discharge, nasal breathing difficulty, and sneezing. The use of irrigation-elimination intranasal therapy with the use of a nasal cavity aspirator can reduce the timing of clinical symptoms of rhinitis and reduce the overall duration of the disease.


2021 ◽  
pp. 118-124
Author(s):  
K. S. Pavlova ◽  
D. S. Mdinaradze

Allergic rhinitis (AR) is one of the most common allergic diseases, especially in economically developed countries, including Russia. The main goal of AR therapy is the control achievement over the disease symptoms, the minimizing of the future exacerbations risks and side effects. Antihistamines and glucocorticosteroids are the main classes of medicines used in all allergic diseases, including AR. According to the Federal Clinical Guidelines for Allergic rhinitis the use of the intranasal corticosteroids in combination with antihistamines is recommended on the second stage of therapy and higher. Both classes of medicines have a complementary effect on the allergic inflammation pathogenesis main stages. The intranasal corticosteroids and antihistamines using allows the delivery of the medicines to the allergic inflammation area directly. Modern intranasal corticosteroids have a high affinity that provides the high efficacy in the low concentrations using and the insignificant systemic bioavailability. The review presents the key characteristics of the olopatadine and mometasone furoate nasal spray in a fixed combination, which registered in the Russian Federation recently. This combination is recommend for use in adults and children over 12 y.o. with allergic rhinitis. The pharmacological characteristics of the nasal spray components including the action mechanism described. The main clinical studies results presented, that confirmed the high efficacy and safety of olopatadine/mometasone furoate combination in AR patients. The olopatadine and mometasone furoate fixed combination ensures the rapid onset and the long-lasting effect with minimal adverse events risks that increases compliance and leads to the control achievement over the AR symptoms.


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