The Fetid Rhinitis or Atrophic Ozena
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| Atrophic rhinitis, medical treatment of atrophic rhinitis, merciful anosmia, ozaena, rhinitis sicca anterior, surgical treatment of atrophic rhinitis, treatment of atrophic rhinitis |
Atrophic rhinitis is the inflammation of the nasal mucosa and the dryness of the nasal mucosa. Mild or severe, depending on the amount indicated, may be acute or chronic, depending on the duration. Viruses, bacteria and allergens can be found in various findings of atrophic rhinitis. In addition to a viral rhinitis usually a bacterial infection is caused by other bacteria such as streptococcus, staphylococcus and pneumococcus. Many factors can facilitate the appearance of atrophic rhinitis (such as bacterial infection, allergens, excessive dryness, exposure to nausea and cold, excessive respiration of the powder, and damage to the nasal mucosa due to viral infection). It is usually insignificant, but some forms can be contagious.
Atrophic rhinitis, whose definition has been made in the last century but whose etiopathogenesis is not yet certain despite the intervening 100 years, is a lifelong chronic disease with extremely disturbing symptoms although it is not fatal. The incidence of atrophic rhinitis has been reported as 2%.
• Hereditary factors: The disease is in family members
• Hormonal imbalance: The disease starts in adolescence and is usually seen in women
• Racial factors: Whiteness is more sensitive than that of equator Africa.
• Food deficiency: vitamins A or D or iron
• Infection: Klebsiella ozaenae, diphtheroids, Proteus vulgaris, E. coli, etc.
• Autoimmune factors: Viral infection or another unidentified triggering factor may affect the antigenic properties of the nasal mucosa
• During nasal surgery, chronic atrophic rhinitis may occur after excessive nasal mucosal injury or tissue defects that affect nasal function (complete removal of nasal feces, empty nasal syndrome), perforation of the nasal septum, and intranasal airflow changes.
Atrophic rhinitis causes
• Hereditary factors: The disease is in family members
• Hormonal imbalance: The disease starts in adolescence and is usually seen in women
• Racial factors: Whiteness is more sensitive than that of equator Africa.
• Food deficiency: vitamins A or D or iron
• Infection: Klebsiella ozaenae, diphtheroids, Proteus vulgaris, E. coli, etc.
• Autoimmune factors: Viral infection or another unidentified triggering factor may affect the antigenic properties of the nasal mucosa
• During nasal surgery, chronic atrophic rhinitis may occur after excessive nasal mucosal injury or tissue defects that affect nasal function (complete removal of nasal feces, empty nasal syndrome), perforation of the nasal septum, and intranasal airflow changes.
Ozena is a term often used in place of atrophic rhinitis or empty nose syndrome. It describes a chronic progressive nasal disease that results in atrophy in the nasal mucosa, scabbing in the nose, foul-smelling discharge, and destruction in submucosal structures. Klebsiella ozaenae is a gram-negative Bacillus. This Bacillus, the cause of atrophic rhinitis, has been described as colonizing the mucosa of the Ora and nasopharynx. It can also be isolated from runny nose, Crouts, and tissue biopsy cultures. Several theories have been put forward to explain pathogenesis. None of this has been confirmed, however. Virulent bacterial infection causing ciliated epithelial damage in the nasal mucosa is recognized as the first trigger for primary atrophic rhinitis. This initiates the chain of events leading to secondary pyogenic osteomyelitis ilemucosa and inflammation in the submucosa in the Conchal bone. Intractable purulent secretion is believed to contribute greatly to the clinical picture by causing saprophytic Klebsiella colonization in an impaired nasal mucociliary clearing environment.
• This disease is more common in women and in patients with low socioeconomic group.
• Nasal cavities can be red, dry, dry. Black or dark green and dry, out of the nasal cavity may produce painful and difficult, odorless shells.
• It is known that microorganisms multiply and produce bad odor from the nose, but patients may not be aware of it because odor nerve endings and odor elements (responsible for odor detection) are atrophic. This is called "merciful anosmia" (one is unaware of the bad smell in his own nose and can not smell)
• Patients complain of nasal obstruction despite the large nasal cavity, which can be a result of obstruction caused by the discharge in the nasal cavity or the sensory loss due to atrophy of the nerves in the nerve, so the patient is unaware of it. In this case, the sensation of nasal congestion is subjective
• Nose bleeding may occur. When the dried shells are removed in the nose, a nosebleed may appear
• Damage to the nasal vestibule, septum perforation and skin inflammation may occur. Nasal deformities may occur
• Atrophic rhinitis, pharynx, or larynx is also associated with similar atrophic changes, and symptoms related to these structures may occur. Hearing impairment due to occlusion of the anterior tube causing middle ear effusion may occur
• After atrophic rhinitis treatment, odor reduction and taste deterioration may persist permanently
Atrophic rhinitis, a chronic rhinitis, is a rare idiopathic disease associated with foul-smelling runny nose, nasal congestion and scabbing. Therefore, it affects the quality of life quite. There is no standard treatment protocol.
The following drugs and applications are used in medical treatment:
• Intra-nasal washing with salt water
• Nasal irrigation and removal of shells using alkaline nasal solutions
• 25% glycose in glycerin can be applied to prevent the growth of proteolytic organisms that produce sweet smell to the nasal mucosa
• Topical antibiotics, such as chloromycetin
• Vitamin D2 (calciferol)
• For regeneration of the seromucinous glands and vascularization of the mucosa, use estradiol spreyi
• Systemic streptomycin against Klebsiella organisms
• oral potassium iodide for liquefaction of the secretions
• Placenta extract injected into the submucosa
Atrophic rhinitis surgical treatment:
Surgical treatments are planned if these medical treatments are not enough and the symptoms of the disease are exacerbated.
Surgical treatment and applications include:
• Young Surgery
• Modified Young Operation
• Nasal cavity narrowing, submucosal injection of Teflon paste, lateral wall of the nose and medial displacement
• Transposition of the parotid duct to maxillary sinus or nasal mucosa
Similar links >> Perforated Nasal Septum May Facilitate the Occurrence of Atrophic Rhinitis! / Dry Nose - Causes, Treatment, Home Remedies
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Clinical findings of atrophic rhinitis
• This disease is more common in women and in patients with low socioeconomic group.
• Nasal cavities can be red, dry, dry. Black or dark green and dry, out of the nasal cavity may produce painful and difficult, odorless shells.
• It is known that microorganisms multiply and produce bad odor from the nose, but patients may not be aware of it because odor nerve endings and odor elements (responsible for odor detection) are atrophic. This is called "merciful anosmia" (one is unaware of the bad smell in his own nose and can not smell)
• Patients complain of nasal obstruction despite the large nasal cavity, which can be a result of obstruction caused by the discharge in the nasal cavity or the sensory loss due to atrophy of the nerves in the nerve, so the patient is unaware of it. In this case, the sensation of nasal congestion is subjective
• Nose bleeding may occur. When the dried shells are removed in the nose, a nosebleed may appear
• Damage to the nasal vestibule, septum perforation and skin inflammation may occur. Nasal deformities may occur
• Atrophic rhinitis, pharynx, or larynx is also associated with similar atrophic changes, and symptoms related to these structures may occur. Hearing impairment due to occlusion of the anterior tube causing middle ear effusion may occur
• After atrophic rhinitis treatment, odor reduction and taste deterioration may persist permanently
Atrophic rhinitis treatment
Atrophic rhinitis, a chronic rhinitis, is a rare idiopathic disease associated with foul-smelling runny nose, nasal congestion and scabbing. Therefore, it affects the quality of life quite. There is no standard treatment protocol.
 |
| Atrophic rhinitis, medical treatment of atrophic rhinitis, merciful anosmia, ozaena, rhinitis sicca anterior, surgical treatment of atrophic rhinitis, treatment of atrophic rhinitis |
Atrophic rhinitis medical treatment
The following drugs and applications are used in medical treatment:
• Intra-nasal washing with salt water
• Nasal irrigation and removal of shells using alkaline nasal solutions
• 25% glycose in glycerin can be applied to prevent the growth of proteolytic organisms that produce sweet smell to the nasal mucosa
• Topical antibiotics, such as chloromycetin
• Vitamin D2 (calciferol)
• For regeneration of the seromucinous glands and vascularization of the mucosa, use estradiol spreyi
• Systemic streptomycin against Klebsiella organisms
• oral potassium iodide for liquefaction of the secretions
• Placenta extract injected into the submucosa
Atrophic rhinitis surgical treatment:
Surgical treatments are planned if these medical treatments are not enough and the symptoms of the disease are exacerbated.
Surgical treatment and applications include:
• Young Surgery
• Modified Young Operation
• Nasal cavity narrowing, submucosal injection of Teflon paste, lateral wall of the nose and medial displacement
• Transposition of the parotid duct to maxillary sinus or nasal mucosa
Similar links >> Perforated Nasal Septum May Facilitate the Occurrence of Atrophic Rhinitis! / Dry Nose - Causes, Treatment, Home Remedies
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
Fax: +90 212 542 74 47
