Rhinitis is a pathology that almost all of us have faced at one time or another. The numbers are increasing as it is estimated that, in its allergic variant, 17% to 29% of European people have it at some point in their lives. This trend is expected to increase, as more and more infants are showing reactions to one or more allergens.
However, it should be noted that not all rhinitis is caused by allergic processes, as it is also commonly due to viral and bacterial infections in the upper respiratory tract. If the clinical picture lasts for more than 6 months, we say that we are facing a chronic rhinitis event..
It is at this moment when the operation for rhinitis begins to be considered, since the quality of life of the patient may be affected. If you want to know everything about this procedure, continue reading.
What is rhinitis?
Rhinitis is defined as an inflammation of the mucosal lining of the nose.It is usually characterized by one or more of these symptoms: discharge of mucous fluid from the nose, sneezing, nasal itching, congestion and postnasal discharge. It is essential to distinguish a rhinitis from a sinusitis, as both clinical entities are often used interchangeably and are not really the same.
A rhinitis causes inflammation in the mucous membranes of the nose, while sinusitis also involves inflammation of the sinuses and nasal passages. For this reason, sinusitis is often referred to medically as “rhinosinusitis”.
What is chronic rhinitis?
A chronic rhinitis is one that evolves in the patient for 6 months or more. Generally, it is an evolution of an acute rhinitis caused by viral or bacterial agents. Some factors can predispose to the nasal passages to be permanently inflamed.Among them, we find the following:
- Anatomical factors: septal deviation, ridges and adenoid hypertrophy in children.
- Infections in neighboring structures: sinusitis or chronic tonsillitis are usually accompanied by rhinitis.
- Vasomotor rhinitis: when the blood vessels of the nose dilate.
- Injuries of a physical-chemical nature: exposure to tobacco, other fumes and irritating substances.
- Hormones and systemic diseases.
- Use of certain medications, such as vasoconstrictors.
Chronic rhinitis causes continuous nasal obstruction and, in severe cases, may lead to crusting, frequent bleeding and secretion of foul-smelling purulent substances. In case of any of these clinical signs, a visit to the doctor is a must.
What is the operation for rhinitis?
We are entering a somewhat complex field, because first of all it is necessary to know if the surgical operation is intended to solve problems derived from rhinitis or sinusitis. According to professional medical portals, there are several methods to deal with chronic rhinitis. We will tell you about them below.
1. Radiofrequency Turbinoplasty
A radiofrequency probe is inserted into the head of the turbinate (structures of spongy bone, covered by respiratory mucosa and located in the lateral parts of each nasal chamber) and several incisions are made in localized spaces. This is done in order to reduce the size of the turbinate, which is hypertrophied and does not allow the patient to breathe..
It is a very safe technique, since it does not damage the adjacent nasal mucosa and does not require general anesthesia in the patient. Unfortunately, the effects of this surgery do not ensure its permanence, as they have an average functionality of about 5 years.
In the weeks following the procedure, it is normal for the patient to have bleeding and even more congestion, which disappears after 5-10 days. Throughout the postoperative period, nasal lavage with saline or hypertonic saline solutions (sea water) should be performed.
2. Turbinoplasty with thermal methods
This is a similar type of intervention, since the objective is still to reduce the size of the hypertrophic nasal turbinates. In this case the wounds are induced by CO2 laser or electrocautery..
3. Turbinoplasty by cold dissection or suction and cutting motor.
Induction of turbinate scars and lesions is performed with cold instruments, separating the turbinate mucosa and bone to induce a more durable scar. It is very effective in cases of chronic shortness of breath, but requires general anesthesia. requires general anesthesia and the patient must wear nasal packing for 2-4 days.
4. Reconstructive turbinectomy with partial section of the turbinate bone and mucosa.
It is the most effective techniqueIn addition to the turbinate itself, bone and mucosa are also partially sectioned. Due to its great specificity and capacity of action, it ensures a better breathing in the patient. Unfortunately, as it is a more delicate procedure, it requires general anesthesia and a slow healing time.
As you can imagine, these interventions are performed when the cause of rhinitis is a hypertrophy of the nasal turbinates.. In the case of other anatomical problems, remodeling these structures will not help. If the cause of your problems is sinusitis, i.e., inflammation of the sinuses, you may require a different surgical intervention.
In this case, what you are trying to solve is a clogging of the sinuses, which can accumulate mucus inside if the drainage is not adequate. For this purpose, an endoscope is introduced with the nostrils, which contains various surgical instruments.
Through this endoscope, the professional can detect polyps, small amounts of bone and other materials that are obstructing the sinuses. He can then cut and perform a laser burn to free the openings. The procedure lasts from 30 to 90 minutes and can be performed under general or local anesthesia, depending on the physician’s indications.
Other types of rhinitis
As you can imagine there is little point in undergoing surgery for allergic rhinitis.. We have presented the operations that are carried out in the most common cases of chronic rhinitis or rhinosinusitis with prolonged duration, although you should bear in mind that many other etiological agents can cause the disease.
In cases of allergic rhinitis, the use of nasal sprays with steroids (which reduce inflammation of the nasal passages), antihistamines (substances that block the function of histamine, essential in allergic processes), decongestants and other drugs are the ways to follow.
On the other hand, if your rhinitis is not allergic and at the same time is not due to inflammation of the turbinates, go to the following list:
- Environmental irritantsIf you work in a factory or on a construction site, for example, continued exposure to dust and other microparticles can promote inflammation of the mucous membranes of the nose.
- Climatic changesExposure to extreme variations in temperature and/or humidity can also cause rhinitis.
- InfectionsIf rhinitis appears out of nowhere and you are not allergic, you are probably suffering from a viral or bacterial infection.
- Food and beveragesSome foods and excess alcohol can cause inflammation of the tissue in the nose.
- Certain medications.
- Hormonal changesHormonal changes from pregnancy, menstruation, oral contraceptive use, or other hormonal conditions can cause non-allergic rhinitis.
- Sleep apnea and gastroesophageal reflux.may exceptionally cause rhinitis.
As you can see after reading this list, we can confirm that there is no single surgical treatment for rhinitis. If it is of allergic origin or if it is due to Gastroesophageal Reflux Disease (GERD), for example, the approach will be very different from if the turbinates are hypertrophied.
In general, episodes of acute rhinitis are very common in the general population, as various groups of viruses, bacteria and allergens can cause it. If you experience some of the above symptoms for a short period of time, do not worry: it is normal.
Things change if the nasal blockages are too recurrent, continuous over time or if they are accompanied by crusts and purulent substances. In these cases a visit to the doctor is necessary immediately.In these cases, a visit to the doctor is necessary immediately, as an infection may have gotten out of control, or worse.