Synechiae of the nasal cavity
Synechiae of the nasal cavity are pathological changes in the nose in the form of connective tissue, cartilage or bone bridges resulting from inflammatory diseases, surgical intervention or injury to the nose. One of the causes of synechiae is infectious diseases in which ulcers form in the nose (diphtheria is characterized by the formation of superficial ulcers covered with crusts; syphilis is accompanied by the formation of deep ulcers with dead cells at the edges, etc.). During normal operation of the respiratory system, the inhaled air flow passing through the nasal passages, where it is cleaned of dust and dirt, which, settling on the nasal mucosa, are removed by the cilia of the epithelium, warms and moisturizes.
The content of the article:
Classification of nasal cavity synechiae
Symptoms of nasal cavity synechiae
Treatment of nasal cavity synechiae
Prognosis and prevention of nasal synechiae
Synechiae of the nasal cavity
Synechiae disrupt the normal air circulation, a person cannot breathe through his nose, inhales uncleaned and cold air through his mouth, which leads to sore throats, laryngitis. Synechiae connect opposite areas of the nasal mucosa, thereby completely or partially obstruct nasal breathing, provoke the development of various respiratory tract diseases — pharyngitis, bronchitis, otitis, pneumonia, etc. The paranasal sinuses stop being ventilated, their inflammations develop — sinusitis, sinusitis. Less often, synechiae in the nose are congenital.
Classification of nasal cavity synechiae
Synechiae of the nasal cavity are divided into congenital and acquired. Congenital synechiae in the nose are formed during the intrauterine period of development and can be both hereditary, the cause may be the transmission of an abnormal gene, and acquired as a result of changes in fetal development in violation of the formation of the facial skull. One of the reasons may be congenital syphilis. Congenital synechiae are most often formed in the posterior parts of the nose and are often diagnosed with hoan atresia.
Belonging to any type, localization, nature of overgrowth is due to the causes of the appearance of synechiae. Most often they are connective tissue, formed from epithelial cells, but sometimes there are bone or cartilage — they are congenital.
Synechiae of the nasal cavity that appeared after birth can occur as a result of the development of scarring and granulation after an inflammatory process, injury or burn with chemicals, surgical intervention, diseases such as lupus, scleroma, diphtheria, typhus, syphilis. Ulcerative processes, coagulation and operations in the nose also provoke the appearance of adhesions. The surfaces of the nasal cavity, devoid of epithelium, fuse together after the formation of exudate. Synechiae can be located in the anterior, posterior or middle part of the nasal cavity. If the anterior part of the nasal cavity is involved in the adhesive process, obstruction of the nostrils is observed. Localization of synechiae in the hoan zone stops the flow of air into the pharynx. Thus, absolute or partial cessation of nasal breathing is a clinical manifestation of the occurrence of synechiae.
Synechiae in the nose differ from other formations in that they spread over a small area, but their tendency to relapse must be taken into account.
Symptoms of nasal cavity synechiae
Small thin jumpers that do not interfere with nasal breathing do not manifest themselves externally. However, with significant overgrowth, the patient’s breathing becomes difficult, the sense of smell and taste deteriorates or is completely absent, the voice becomes nasal, snoring appears, the sinuses become inflamed in the form of sinusitis or sinusitis. Symptoms may appear in the form of neuralgia, tinnitus, nasal congestion, sticking of crusts on the mucous membrane. Localization of synechiae in the middle part of the nasal cavity is accompanied by headache, throat or ear diseases. In the case of the location of synechiae in the upper parts of the nose, there is a discharge of thick, difficult-to-remove mucus. As with ozen, synechiae of the nasal cavity provoke the constant formation of crusts in the nose.
An otolaryngologist diagnoses synechiae in the nose. During the survey, the doctor determines one- or two-sided difficulty in breathing, at what time of day, when the patient first noticed a respiratory disorder, whether there are periods of exacerbation and remission, etc. Anterior synechiae are detected by visual examination, the middle and posterior ones are detected by rhinoscopy. What in their structure these splices are established by probing with a button probe. To diagnose concomitant diseases, pharyngoscopy, examination of the paranasal sinuses, patency of the auditory tube, laryngoscopy, and smear examinations are performed.
Congenital nasal pathologies are usually diagnosed up to a year. In infants, synechiae in the nose cause a violation of sucking, if the nasal passages completely overlap, at birth there is a lack of screaming and the first breath, breathing disorders, anxiety, cyanosis of the face. In newborns, congenital synechiae in the nose can be immediately subjected to surgical intervention, since severe violations of the respiratory system can threaten the life of the child.
Treatment of nasal cavity synechiae
The treatment of synechiae in the nose consists in excision of them during surgery using endotracheal anesthesia or local anesthesia. Connective tissue splices are removed with a scalpel, cartilaginous ones are removed with a conchotome, and bone ones are hollowed out with a chisel. This unpleasant and complicated procedure allows you to remove the bone formation and restore the lumen of the chaona. In parallel with the removal of synechiae, it is possible to perform other operations on the nasal shells. Endoscopic removal of splices is the most gentle method, as it is carried out under local anesthesia and the rehabilitation period is significantly reduced. Less traumatic is the use of laser surgery, when using laser beams, rapid healing occurs, which eliminates the recurrence of the development of adhesions. The use of the Surgitron apparatus for excision of splices by radio wave action also has an advantage. The operation is performed under local anesthesia with minimal blood loss and tissue damage, sometimes performed on an outpatient basis.
To prevent the re-formation of the adhesive process after surgery during the healing period, rubber tubes, special foil or celluloid, glove rubber, turunds with wound healing ointments are inserted into the nasal cavity. Treatment can last about six months before the wound surface is covered with a healthy epithelium.
To prevent the disease, galvanocaustics should not be performed or the nasal mucosa of the opposite areas should be cauterized. In case of the need for these procedures, it is necessary to prevent the occurrence of scars by disconnecting the splices with the help of special materials.
If synechiae do not bother, do not significantly disrupt nasal breathing, they should not be operated on, since scarring after surgery can provoke even greater problems.
Prognosis and prevention of nasal synechiae
Synechiae are very prone to relapse, new scarring leads to repeated overgrowth, deformation of the nose. Therefore, the occurrence of synechiae of the nasal cavity is better avoided than treated. Prevention consists in the correct and appropriate treatment of respiratory diseases, reducing cases of injury to the nose. In these cases, you should contact an ENT doctor for competent treatment and exclusion of curvature of the nasal septum. In the postoperative period, it is very important to regularly visit a doctor for proper nasal toilet with endoscopic control to prevent the formation of new scar bridges. When working with toxic substances, in harmful conditions, safety rules should be observed, personal protective equipment should be used — respirators, masks so as not to damage the mucous membrane.
