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Atrophic rhinitis

Atrophic rhinitis, also known as rhinitis sicca or ozena is a chronic rhinitis (inflammation) of nose characterised by atrophy (thinning) and drying of the nasal mucosa including the glands, turbinate bones and the nerve elements supplying the nose. Atrophic Rhinitis is of two types: primary and secondary to nasal surgery, trauma and irradiation. The mucous secreting normal cells of the nose having cilia are replaced by cells like those normally found in the skin. A prolonged bacterial infection of the nasal mucosa is one of the risk factor.

The first sign often is the smell of the patient, often severe. Paradoxically, this likely will cause distress to everyone except the patient, due to the prevalent finding of anosmia. Another prominent finding is nasal crusting. The crusts are often extensive, filling the entire nasal cavity. Removal of these crusts may induce bleeding. Treatment is aimed at reducing the crusting, eliminating the odor and reducing infections. Topical antibiotics, such as bacitracin applied inside the nose, help kill bacteria. Estrogens and vitamins A and D sprayed into the nose or taken orally may reduce crusting by promoting mucosal secretions. Antibiotics, oral or intravenous are also helpful. Surgery to narrow the nasal passages may reduce crusting because the decreased airflow prevents drying of the thinned mucous membrane.

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