Atrophic rhinitis (Ozena)

Atrophic rhinitis (Ozena) is a rare chronic inflammatory disease that affects the lining of the nasal cavity. This condition is characterized by a wasting away or an atrophy of the bony ridges and the mucus membranes inside of the nasal cavity. It is characterized by progressive nasal mucosal atrophy, nasal crusting, fetor, and enlargement of the nasal space with paradoxical nasal congestion.
The nasal cavities are roomy with lot of crusts which is foul smelling.
Exact cause unknown, but Endocrine, nutritional deficieancy, autoimmune causes, infective etiology are blamed.

Pathology

The ciliary epithelium is replaced by stratified squamous epithelium, atrophy of mucous glands.The turbinates also atrophy.

Symptoms

The symptoms include nasal crusting, discharge, and a bad odor

Examination of the nasal passage shows greenish discharge. Septal perforation may co exist.

Treatment

Nasal irrigation with alkaline solution(1 litre boiled and cold water add 1 tsp salt, sugar and soda bicarb) or normal saline.
25%glucose in glycerin nasal drops
Local antibiotic ointment, drops
Systemic antibiotics with anerobic cover.

Surgery

The aim of surgery is either to narrow the nasal cavity or in special cases to close the nostril. Closure of the nostril (Young’s operation), is achieved by raising a circular skin flaps. Raising the skin flap is difficult, the suture line may break down and an excessive scar tissue may form resulting in vestibular stenosis.

Modified Young’s operation aim at partial closure of nostrils one at a time.

Prognosis

There is a tendency to recover spontaneosly.