Chronic atrophic rhinitis

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Chronic atrophic rhinitis
Specialty Otorhinolaryngology   OOjs UI icon edit-ltr-progressive.svg

Chronic atrophic rhinitis (often simply atrophic rhinitis) is a chronic inflammation of the nose characterised by atrophy of nasal mucosa, including the glands, turbinate bones and the nerve elements supplying the nose. Chronic atrophic rhinitis may be primary and secondary. Special forms of chronic atrophic rhinitis are rhinitis sicca anterior and ozaena. It can be described by empty nose syndrome.

Contents

Signs and symptoms

Etiology

Causes can be remembered by the mnemonic HERNIA:

Secondary atrophic rhinitis

Specific infections, such as syphilis, leprosy and rhinoscleroma, may cause destruction of the nasal structures leading to atrophic changes. Atrophic rhinitis can also result from long-standing purulent sinusitis or radiotherapy of the nose, or as a complication of surgery of the turbinates. [4] The United Kingdom National Health Service has stated that "Most cases of atrophic rhinitis in the UK occur when the turbinates are damaged or removed during surgery". [5] Some authors refer to as Atrophic rhinitis secondary to sinus surgery as the empty nose syndrome. [4]

Unilateral atrophic rhinitis

Extreme deviation of nasal septum may be accompanied by atrophic rhinitis on the wider side.

Pathology

Diagnosis

Diagnosis is based on clinical history and examination. Examination is clinical, via anterior rhinoscopy and fibreoptic, using nasendoscopy. A CT scan can be used to confirm the diagnosis and review disease extent.

Treatment

Treatment of atrophic rhinitis can be either medical or surgical.

Medical measures include:

Surgical interventions include:

History

This disorder was known since the time of ancient Egypt, almost 4,000 years ago, and descriptions of it are found in the historical medical papyri. In the Edwin Smith Papyrus (1700 BC) it was prescribed a treatment based on wine and breast milk to cure this disease. [4] The ancient Greek and Indian civilizations were aware of atrophic rhinitis. [8]

See also

References

  1. Dutt SN, Kameswaran M (November 2005). "The aetiology and management of atrophic rhinitis". J Laryngol Otol. 119 (11): 843–52. doi: 10.1258/002221505774783377 . PMID   16354334.
  2. Bunnag C, Jareoncharsri P, Tansuriyawong P, Bhothisuwan W, Chantarakul N (September 1999). "Characteristics of atrophic rhinitis in Thai patients at the Siriraj Hospital". Rhinology. 37 (3): 125–30. PMID   10567992.
  3. Bist, Sampan S.; Bisht, Manisha; Purohit, Jagdish P. (2012-11-19). "Primary Atrophic Rhinitis: A Clinical Profile, Microbiological and Radiological Study". ISRN Otolaryngology. 2012. Hindawi Limited: 1–6. doi: 10.5402/2012/404075 . ISSN   2090-5750.
  4. 1 2 3 4 deShazo, Richard D.; Stringer, Scott P. (2011-02-01). "Atrophic rhinosinusitis: progress toward explanation of an unsolved medical mystery". Current Opinion in Allergy and Clinical Immunology. 11 (1): 1–7. doi:10.1097/ACI.0b013e328342333e. ISSN   1473-6322. PMID   21157302. S2CID   27205163.
  5. Choices, NHS. "Non-allergic rhinitis - Causes - NHS Choices". www.nhs.uk. Retrieved 2017-08-12.
  6. 1 2 Gleeson, Michael; Clarke, Ray (2008-04-25). Scott-Brown's Otorhinolaryngology: Head and Neck Surgery 7Ed: 3 volume set. CRC Press. ISBN   9781444109832.
  7. Gleeson, Michael; Clarke, Ray (2008-04-25). Scott-Brown's Otorhinolaryngology: Head and Neck Surgery 7Ed: 3 volume set. CRC Press. ISBN   9781444109832.
  8. Shehata MA (1996). "Atrophic rhinitis". Am J Otolaryngol. 17 (2): 81–6. doi:10.1016/s0196-0709(96)90000-9. PMID   8820180.