Vasomotor rhinitis is a common chronic nasal disorder characterized by dysregulation of the autonomic nervous system, leading to abnormal vascular responses in the nasal mucosa. Unlike allergic rhinitis, it is not associated with immunoglobulin E-mediated mechanisms but is influenced by environmental, hormonal, and neurogenic factors.
In women of reproductive age, endocrine disturbances such as hypothyroidism may significantly influence nasal physiology. Reduced thyroid hormone levels can lead to mucosal edema, decreased ciliary activity, and impaired mucociliary transport. The mucociliary clearance system is a primary defense mechanism of the respiratory tract, responsible for the elimination of inhaled particles, microorganisms, and excess mucus. Dysfunction of this system predisposes patients to persistent nasal symptoms and recurrent infections.
Despite the clinical importance of this interaction, the relationship between hypothyroidism and mucociliary clearance in vasomotor rhinitis remains insufficiently studied. This research aims to address this gap by evaluating functional changes in mucociliary activity and their clinical implications.
The purpose of this study is to analyze the functional state of nasal mucociliary transport in women of reproductive age diagnosed with vasomotor rhinitis in the presence of thyroid hormone deficiency. The research is aimed at identifying the extent to which endocrine imbalance influences the efficiency of mucosal defense mechanisms within the nasal cavity.
Particular attention is given to evaluating alterations in ciliary activity, mucus properties, and transport dynamics, as well as their contribution to the persistence and severity of nasal symptoms. The study also seeks to determine the relationship between hormonal status and the duration of mucociliary clearance, using objective diagnostic methods.
In addition, the investigation examines how impaired mucociliary function affects susceptibility to chronic inflammation and recurrent upper respiratory tract conditions. Comparative analysis between patients with and without hypothyroidism is performed to better understand the specific impact of endocrine factors.
The overall goal is to provide a comprehensive assessment that supports early identification of functional impairment and contributes to the development of targeted therapeutic strategies aimed at restoring mucociliary function and improving clinical outcomes in this patient population.
MATERIALS AND METHODS
A prospective comparative study was conducted involving 80 women aged 18–40 years. The study group included patients diagnosed with vasomotor rhinitis and hypothyroidism, while the control group consisted of patients with vasomotor rhinitis without thyroid dysfunction. Diagnosis of hypothyroidism was confirmed by serum levels of TSH, T3, and T4.
Mucociliary clearance was evaluated using the saccharin transit test, measuring the time required for the subject to perceive a sweet taste after placement of a saccharin particle in the nasal cavity. Additional assessments included nasal endoscopy, symptom scoring, and laboratory analysis. Statistical analysis was performed to compare clearance times and clinical parameters between groups.
Patients with hypothyroidism demonstrated significantly prolonged mucociliary clearance times compared to the control group (p < 0.01). The average saccharin transit time was increased by 35–50%, indicating reduced ciliary efficiency. Clinical symptoms such as nasal congestion and rhinorrhea were more severe in the study group. A positive correlation was observed between elevated TSH levels and delayed mucociliary transport. Endoscopic findings revealed mucosal edema and increased secretions in patients with combined pathology.
The results confirm that hypothyroidism has a significant negative impact on mucociliary clearance in patients with vasomotor rhinitis. Hormonal deficiency leads to structural and functional changes in the nasal mucosa, including reduced ciliary beat frequency and altered mucus composition. These changes impair the natural defense mechanisms of the respiratory tract and contribute to chronic symptom persistence.
The study highlights the importance of considering endocrine factors in the evaluation and management of chronic nasal disorders. комплекс (integrated) approaches addressing both hormonal imbalance and local nasal pathology are essential for improving treatment outcomes. Limitations include sample size and single-center design.
Impaired mucociliary clearance is a key feature in women with vasomotor rhinitis and hypothyroidism. Early detection and correction of thyroid dysfunction, combined with appropriate ENT management, can significantly improve nasal function and patient quality of life. Integrated therapeutic strategies should be emphasized in clinical practice to achieve optimal outcomes.
[1] Med1.uz. Otit (quloq kasalliklari) – sabablari, belgilari va davolash. Available from: https://med1.uz/articles/lor/quloq-kasalliklari-otit
[2] Med1.uz. Menyer kasalligi (ichki quloq kasalligi) – diagnostika va davolash. Available from: https://med1.uz/articles/lor/menyer-kasalligi-ichki-quloq
[3] Med1.uz. Sinuzit – sabablari, klinikasi va davolash usullari. Available from: https://med1.uz/articles/lor/sinuzit
[4] Med1.uz. Allergik rinit – belgilari va davolash yo‘llari. Available from: https://med1.uz/articles/lor/allergik-rinit
[5] Med1.uz. Laringit – etiologiya, simptomlar va davolash. Available from: https://med1.uz/articles/lor/laringit
[6] Rosenfeld RM, Shin JJ, Schwartz SR, et al. Clinical practice guideline: Otitis media with effusion. Otolaryngol Head Neck Surg. 2016;154(1S):S1-S41.
[7] Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics. 2013;131(3):e964-e999.
[8] Schilder AGM, Marom T, Bhutta MF, et al. Otitis media. Nat Rev Dis Primers. 2016;2:16063.
[9] Monasta L, Ronfani L, Marchetti F, et al. Burden of disease caused by otitis media. Pediatrics. 2012;129(5):e1053-e1061.
[10] Lopez-Escamez JA, Carey J, Chung WH, et al. Diagnostic criteria for Menière’s disease. J Vestib Res. 2015;25(1):1-7.
[11] Basura GJ, Adams ME, Monfared A, et al. Clinical practice guideline: Menière’s disease. Otolaryngol Head Neck Surg. 2020;162(2S):S1-S55.
[12] Rauch SD. Clinical practice: Menière’s disease. N Engl J Med. 2010;362(18):1701-1707.
[13] Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(S29):1-464.
[14] Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline: Adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(2S):S1-S39.
[15] Wald ER, Applegate KE, Bordley C, et al. Clinical practice guideline for acute bacterial sinusitis. Pediatrics. 2013;132(1):e262-e280.
[16] Bousquet J, Khaltaev N, Cruz AA, et al. Allergic Rhinitis and its Impact on Asthma (ARIA). Allergy. 2008;63(Suppl 86):8-160.
[17] Brożek JL, Bousquet J, Agache I, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines—2016 revision. J Allergy Clin Immunol. 2017;140(4):950-958.
[18] Greiner AN, Hellings PW, Rotiroti G, Scadding GK. Allergic rhinitis. Lancet. 2011;378(9809):2112-2122.
[19] Seidman MD, Gurgel RK, Lin SY, et al. Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg. 2015;152(1S):S1-S43.
[20] Schwartz SR, Magit AE, Rosenfeld RM, et al. Clinical practice guideline: Hoarseness (dysphonia). Otolaryngol Head Neck Surg. 2018;158(1S):S1-S42.
[21] Sulica L. Laryngitis and voice disorders. N Engl J Med. 2019;381(7):678-679.
[22] Altman KW, Stephens RM, Lyttle CS, Weiss KB. Changing impact of laryngeal disorders. Laryngoscope. 2005;115(7):1236-1239.