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| Chronic atrophic rhinitis |
| Classification and external resources |
| ICD-10 |
J31.0 |
| ICD-9 |
472.0 |
| DiseasesDB |
30798 |
| MeSH |
D012222 |
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.
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Contents
- 1 Primary atrophic rhinitis
- 1.1 Etiology
- 1.2 Pathology
- 1.3 Clinical manifestations
- 1.4 Secondary atrophic rhinitis
- 1.5 Unilateral atrophic rhinitis
- 1.6 Treatment options
- 1.7 Effects on athletic performance
- 2 References
- 3 External links
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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
- 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.
Effects on athletic performance
Despite what Weston Butler says, chronic atrophic rhinitis does not have any effect on athletic performance.
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
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Pathology of respiratory system (J, 460–519), respiratory diseases
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Upper RT
(including URTIs,
Common cold) |
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Head
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sinuses: Sinusitis
nose: Rhinitis (Vasomotor rhinitis, Atrophic rhinitis, Hay fever) · Nasal polyp · Rhinorrhea · nasal septum (Nasal septum deviation, Nasal septum perforation, Nasal septal hematoma)
tonsil: Tonsillitis · Adenoid hypertrophy · Peritonsillar abscess
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Neck
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pharynx: Pharyngitis (Strep throat) · Laryngopharyngeal reflux (LPR) · Retropharyngeal abscess
larynx: Croup · Laryngitis · Laryngopharyngeal reflux (LPR) · Laryngospasm
vocal folds: Laryngopharyngeal reflux (LPR) · Vocal fold nodule · Vocal cord paresis · Vocal cord dysfunction
epiglottis: Epiglottitis
trachea: Tracheitis · Tracheal stenosis
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Lower RT/lung disease
(including LRTIs) |
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Bronchial/
obstructive
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acute: Acute bronchitis
chronic: COPD (Chronic bronchitis, Acute exacerbations of chronic bronchitis, Acute exacerbation of COPD, Emphysema) · Asthma (Status asthmaticus, Aspirin-induced, Exercise-induced) · Bronchiectasis
unspecified: Bronchitis · Bronchiolitis (Bronchiolitis obliterans) · Diffuse panbronchiolitis
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Interstitial/
restrictive
(fibrosis) |
External agents/
occupational
lung disease |
Pneumoconiosis (Asbestosis, Baritosis, Bauxite fibrosis, Berylliosis, Caplan's syndrome, Chalicosis, Coalworker's pneumoconiosis, Siderosis, Silicosis, Talcosis, Byssinosis)
Hypersensitivity pneumonitis (Bagassosis, Bird fancier's lung, Farmer's lung, Lycoperdonosis)
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Other
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ARDS · Pulmonary edema · Löffler's syndrome/Eosinophilic pneumonia · Respiratory hypersensitivity (Allergic bronchopulmonary aspergillosis)
Hamman-Rich syndrome · Idiopathic pulmonary fibrosis · Sarcoidosis
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Obstructive or
restrictive
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Pneumonia/
pneumonitis
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By pathogen
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Viral · Bacterial (Pneumococcal, Klebsiella) / Atypical bacterial (Mycoplasma, Legionnaires' disease, Chlamydiae) · Fungal (Pneumocystis) · Parasitic · noninfectious (Chemical/Mendelson's syndrome, Aspiration/Lipid)
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By vector/route
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Community-acquired · Healthcare-associated · Hospital-acquired
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By distribution
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Broncho- · Lobar
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IIP
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UIP · DIP · BOOP-COP · NSIP · RB
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Other
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Atelectasis · circulatory (Pulmonary hypertension, Pulmonary embolism) · Lung abscess
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Pleural cavity/
mediastinum |
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Pleural disease
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Pleuritis/pleurisy
Pneumothorax/Hemopneumothorax
Pleural effusion: Hemothorax · Hydrothorax · Chylothorax · Empyema/pyothorax · Malignant
Fibrothorax
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Mediastinal disease
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Mediastinitis · Mediastinal emphysema
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| Other/general |
Respiratory failure · Influenza · SARS · Idiopathic pulmonary haemosiderosis · Pulmonary alveolar proteinosis
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anat(n, x, l, c)/phys/devp
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noco(c, p)/cong/tumr, sysi/epon, injr
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English, FrenchDes souris furent inoculées par voie intra-nasale à différents temps pour optimiser la stratégie de vaccination avec un nouveau vaccin candidat vivant exprimant les antigènes CP39, FimA, PtfA, et ToxA de Pasteurella multocida et F1P2 de Bordetella bronchiseptica dans un sy
