Chronic atrophic rhinitis, or 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 also be described as the empty nose syndrome.
Chronic atrophic rhinitis | |
---|---|
Specialty | Otorhinolaryngology |
Causes can be remembered by the mnemonic HERNIA:
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.[3] 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".[4] Some authors refer to as Atrophic rhinitis secondary to sinus surgery as the empty nose syndrome.[3]
Extreme deviation of nasal septum may be accompanied by atrophic rhinitis on the wider side.
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 of atrophic rhinitis can be either medical or surgical.
Medical measures include:
Surgical interventions include:
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.[3] The ancient Greek and Indian civilizations were aware of atrophic rhinitis.[7]