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an inflammation of the mucous membrane lining the nose (usually associated with nasal discharge) (同)coryza
relating to or characterized by atrophy; "atrophic arthritis"

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鼻炎

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/04/21 00:36:38」(JST)

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"Ozaena" redirects here. For the genus of ground beetles, see Ozaena (beetle).

Chronic atrophic rhinitis is a chronic inflammation of 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.

Primary atrophic rhinitis

Etiology

Heredity factors: the disease runs in families
Endocrine imbalance: the disease tends to start at puberty and mostly involves females
Racial factors: whites are more susceptible than natives of equatorial Africa
Nutritional deficiency: vitamins A or D, or iron^{[citation needed]}
Infection: Klebsiella ozaenae, diphtheroids, Proteus vulgaris, E. coli, etc.
Autoimmune: viral infection or some other unidentified insult may trigger antigenicity of the nasal mucosa.

Pathology

The ciliated columnar epithelium of the nasal mucosa is replaced by stratified squamous epithelium. Atrophy of mucosa, turbinal bones and seromucinous glands tends to occur, due to obliterative endarteritis causing decreased blood supply, hence the supplying area atrophies.

Clinical manifestations

The disease is most commonly seen in females, and tends to appear during puberty. It can occur, however, as early as 12 months of age. The nasal cavities become roomy and are filled with foul smelling crusts which are black or dark green and dry, making expiration painful and difficult. Microorganisms are known to multiply and produce a foul smell from the nose, though the patients may not be aware of this, because their elements (responsible for the perception of smell) have become atrophied. Patients usually complain of nasal obstruction despite the roomy nasal cavity, which can be caused either by the obstruction produced by the discharge in the nose, or as a result of sensory loss due to atrophy of nerves in the nose, so the patient is unaware of the air flow. In the case of the second cause, the sensation of obstruction is subjective. Bleeding from the nose, also called epistaxis, may occur when the dried discharge (crusts) are removed. Septal perforation and dermatitis of nasal vestibule can occur. The nose may show a saddle-nose deformity. Atrophic rhinitis is also associated with similar atrophic changes in the pharynx or larynx, producing symptoms pertaining to these structures. Hearing impairment can occur due to Eustachian tube blockage causing middle ear effusion.

Permanent loss of smell and impairment of taste may also be a result of this disease, even after the symptoms are cured.

Secondary atrophic rhinitis

Specific infections, such as syphilis, lupus, leprosy and rhinoscleroma, may cause destruction of the nasal structures leading to atrophic changes. Atrophic rhinitis can also result from long-standing purulent sinusitis, radiotherapy of the nose or excessive surgical removal of turbinates.

Unilateral atrophic rhinitis

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

Treatment options

Treatment of atrophic rhinitis can be either medical or surgical.

Medical measures include:

Nasal irrigation using normal saline
Nasal irrigation and removal of crusts using alkaline solutions
25% glucose in glycerine can be applied to the nasal mucosa to inhibit the growth of foul-smelling proteolytic organisms
Local antibiotics, such as chloramphenicol (Kemicetine)
Estradiol and vitamin D₂
Estradiol spray
Systemic streptomycin
Oral potassium iodide
Placental extract injected in the submucosa

Surgical interventions include:

Young's operation
Modified Young's operation
Narrowing of nasal cavities, submucosal injection of Teflon paste, section and medial displacement of the lateral wall of the nose
Transposition of parotid duct to maxillary sinus or nasal mucosa

References

External links

-1013317582 at GPnotebook

UpToDate Contents

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English Journal

Phenotypic Characterization and Random Amplified Polymorphic DNA (RAPD) analysis of <i>Pasteurella multocida</i> isolated from Korean Pigs.

Lee KE, Jeoung HY, Lee JY, Lee MH, Choi HW, Chang KS, Oh YH, An DJ.SourceAnimal, Plant and Fisheries Quarantine and Inspection Agency, Anyang, Gyeonggi-do, 430-824, South Korea.
The Journal of veterinary medical science / the Japanese Society of Veterinary Science.J Vet Med Sci.2012 Jun 7;74(5):567-73. Epub 2011 Dec 13.
Pasteurella multocida causes various respiratory disease symptoms in pigs, including atrophic rhinitis and pneumonia. In the present study, 69 strains of P. multocida were isolated from 443 pigs with respiratory clinical symptoms at 182 farms located throughout South Korea from 2009 to 2010. A multi
PMID 22167105

Japanese Journal

Phenotypic Characterization and Random Amplified Polymorphic DNA (RAPD) analysis of Pasteurella multocida isolated from Korean Pigs

LEE Ki-Eun,JEOUNG Hye-Young,LEE Ji-Youn,LEE Myoung-Heon,CHOI Hwan-Won,CHANG Kyung-Soo,OH Young-Hee,AN Dong-Jun
Journal of Veterinary Medical Science 74(5), 567-573, 2012
… Pasteurella multocida causes various respiratory disease symptoms in pigs, including atrophic rhinitis and pneumonia. …
NAID 130001410434

わが国のARにおける毒素原性 Pasteurella の重要性とトキソイド開発

河合透,牛島稔大
日本豚病研究会報 = Proceedings of the Japanese Pig Veterinary Society (55), 4-7, 2009-08-01
わが国のARにおける毒素原性Pasteurellaの重要性とトキソイド開発。この度は、栄えある第16回藤崎優次郎賞を賜わりまして心から感謝申し上げます。私どもが財団法人化学及血清療法研究所に入所して間もない頃、1987年4月にAR（ボルデテラ）生ワクチンが製造承認され、同年12月に発売されました。しかし、翌年3月頃から本ワクチン接種豚にAR症状がみられるという症例が各地から寄せられたことから、その …
NAID 10029862211