The (nasal) perils of growing old…!
Rhinitis is the general term used to describe inflammation of the nasal lining. In simple terms, this is due to either ‘ALLERGIC’ or ‘NON-ALLERGIC’ causes, with the latter being mainly due to long standing nasal and sinus infection. There are, however, a myriad of other rarer but no less irritating causes of Rhinitis, and the diagnosis and treatment of all these issues is my aim for you in The Canterbury Nose Clinic.
As our population ages, I see an increasing number of elderly patients with real issues with watery nasal discharge and nasal blockage caused by what has been unkindly described ‘Senile Rhinitis’. I have seen 3 Ladies with this condition this week ! When I mentioned the probable cause of her problems to one extremely sprightly and entertaining Lady I saw, she took real exception to being classed as senile, although admitting later that she was 92 years old. I think she did forgive me when I apologised that this was not my terminology, and she has subsequently given me a copy of her Autobiography (both volumes!) and written me a charming poem, which I share with you below…
To write a poem on ‘Catarrh’ has tested my linguistic skills!
(Perhaps these rhyming couplets are just comments on my nasal ills,
Or merely lines I shall compose, to tell about my runny nose?)
The NHS has failed to find an answer to this simple grief,
For everyone, it seems, is blind to sinus sniffs and cold relief.
At 92, it’s quite ironic to have your snuffles labelled ‘CHRONIC’!
Although they didn’t find a cure, I’ve confidence in ENT,
and Kleenex tissues can ensure no-one spots the drips but me.
So, to be blunt, I shouldn’t carp; I’m really glad the boss was Sharp !
As she so eloquently writes, unfortunately the successful treatment of this condition is often difficult. No-one really knows the cause of it, but it is thought to be due to overactivity of the (parasympathetic) nerve supply to the nasal lining. The most important thing to do is to get the cause of the Rhinitis properly investigated and diagnosed. As I have mentioned (and particularly as one gets older) there are many different causes of nasal symptoms such as this, and the important thing is to rule out any more sinister causes before commencing treatment.
As with many causes of rhinitis, Senile Rhinitis may respond to a steroid nasal spray, but more commonly may get better with an (anticholinergic) nasal spray which specifically blocks the activity of the nerves which stimulate the nasal lining to produce mucus (Ipratropium Bromide or Rinatec Nasal Spray.) Saline Nasal Douches may help to flush out mucous and keep the nose clear.
There is also an operation to cut the main nerve supply to the nasal lining called Vidian Neurectomy. This operation was previously tried in the 70’s and 80’s, but has enjoyed somewhat of a comeback recently as the use of endoscopes and specialised instruments in the nose has developed, as well as with the improvement in advanced rhinological surgical expertise. The jury is still out somewhat on the long term results of this operation, and clearly one has to take into account it’s efficacy, and the considerations of a General Anaesthetic in elderly patients who may have concurrent other health problems.
Watch this space though…
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