1. ATROPHIC RHINITIS
MEGHA.V
4061

2. CONTENTS:
•
•
•
•
•
•
•
•
•
DEFINITION
HISTORY
ETIOLOGY
PATHOLOGY
SYMPTOMS & SIGNS
RADIOLOGICAL FINDINGS
COMPLICATIONS
DIFFERENTIAL DIAGNOSIS
TREATMENT

3. DEFINITION
CHRONIC INFLAMMATORY DISEASE
ATROPHY

4. HISTORY
• Dr. Spencer Watson(1875)
• Dr. Bernhard Fraenkel(1876) : TRIAD of
atrophy
fetor
crusts

5. Synonyms:
• OZAENA
• MERCIFUL ANOSMIA
• DRY RHINITIS

6. ETIOLOGICAL TYPES
•PRIMARY ATROPHIC
RHINITIS
•SECONDARY ATROPHIC
RHINITIS

7. CAUSES OF PRIMARY ATROPHIC
RHINITIS
HERNIA

8. HERNIA
HEREDITY

9. HERNIA
ENDOCRINAL
DISTURBANCE

10. HERNIA
RACIAL FACTORS

11. HERNIA
NUTRIONAL DEFICIENCY

12. HERNIA
INFECTIVE

13. HERNIA
AUTOIMMUNE
PROCESS

14. SECONDARY ATROPHIC RHINITIS
1. Chronic specific infections
Lupus
vulgaris
syphilis
leprosy

15. SECONDARY ATROPHIC RHINITIS
2. Extensive surgery of the nose
(turbinectomy)

16. SECONDARY ATROPHIC RHINITIS
3. Severe deviated nasal septum

17. PATHOLOGY:
• Microscopic changes
NORMAL

18. squamous metaplasia
Absence of cilia
Atrophy of
muscosal glands

20. Normal
Atrophy of nerve endings and
olfactory nerve

22. Why nasal obstruction even in the
presence of roomy nasal cavity?

23. Why nasal obstruction even in the
presence of roomy nasal cavity?
PARADOXICAL NASAL
OBSTRUCTION

24. SIGNS :
EXTERNAL NOSE:

25. SIGNS :
ANTERIOR RHINOSCOPY:
ATROPHIED
TURBINATES
GREENISH FOUL
SMELLING
CRUSTS
PALE & ATROPHIC MUCOSA

26. Radiological findings :
• Mucoperiosteal thickening of paranasal sinuses
• Loss of definition of osteomeatal complex
• Enlargement of nasal cavity with erosion and
bowing of the lateral nasal wall
• Atrophy of inferior and middle turbinates
• hypoplastic maxillary sinuses

29. Differential diagnosis

30. Differential diagnosis

31. Differential diagnosis

32. TREATMENT
MEDICAL THERAPY - LOCAL
SYSTEMIC
 SURGICAL THERAPY

33. ALKALINE NASAL DOUCHE

34. Sodium biborate (28.4 g)
Sodium carbonate (28.4 g)
Sodium chloride (56.7 g)
mixed in 280 ml of luke warm water.

35. Nasal drops
• 25% glucose in glycerine
 Chloramphenicol &
streptomycin drops
 oetradiol spray

36. Kemicetine(local antibiotic)

37. Placental Extracts

38. Potassium iodide

39. Systemic :
• Streptomycin (1 g/day)
• Vitamin A
• Vasodilators

40. Surgical :
•
•
•
•
•
•
Young’s operation
Modified young’s operation
Wilson’s procedure
Whitmaack’s operation
Other volume reduction procedures
Denervating operations

41. Young’s operation

42. Modified Young’s operation

43. Quick note for treatment of atrophic rhinitis
ATROPI In Young Girls
A- antibiotic spray
T- teflon paste
R- remove crust
O- oetradiol therapy
P-potassium iodide ,placental extracts
I- irrigation
In- insertion of fat,cartilage
Y- young’s operation
G-glucose in glycerine
Girls- (more in females)

44. References :
• A short book of E.N.T (K.B.bhargava), 9th
edition,”atrophic rhinitis”,pg 158.
• Diseases of E.N.T ,P.L.Dhingra,5th edition
• http://www.drtbalu.co.in/atro_rhinitis.html
• http://www.utmb.edu/otoref/grnds/Atrophic-R
hinitis-050330/Atrophic-Rhinitis-050330.htm