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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board
(Ozena)

Definition

Atrophic rhinitis is a shrinking of the bone and tissue that lines the inside of the nose. This can make it hard for the nose to work as it should. There are two types, primary and secondary.

Causes

Primary atrophic rhinitis does not have a known cause.

Secondary atrophic rhinitis is caused by an illness or event such as:

  • Nasal trauma
  • Nasal surgery
  • Radiation exposure

Risk Factors

Things that may raise the risk of primary atrophic rhinitis are:

  • Certain infections
  • Genetics
  • Poor nutrition
  • Problems with hormone levels
  • Low levels of iron in the blood
  • Problems with the immune system

Things that may raise the risk of secondary atrophic rhinitis are:

  • Lupus
  • Sinus inflammation
  • Surgery

Symptoms

Problems may be:

  • A bad odor coming from the nose or mouth
  • Nasal discharge
  • Crusting and dryness inside the nose
  • Nasal blockage or congestion
  • Nosebleeds
  • Loss of smell
  • Headache
  • Wide nasal cavities

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Tests may be done to rule out other problems, such as allergies. Tissue from inside the nose may need to be tested. This can be done with a biopsy. Other tests may include:

  • X-ray
  • CT scan
  • Endoscopy—a lighted tube with a small camera that is inserted into the nose

Treatment

The goal of treatment will be to ease symptoms. The shrinking of tissue increases the size of the nasal cavity. This increases airflow and can cause more irritation of the nasal cavity lining. Good care of the lining may help. First line of treatment may include:

  • Nasal irrigation—solution is flushed through the nasal and sinus cavity. It can help to clear crust build up and moisturize the nose. This may be done with tools such as a neti-pot, bulb syringe, or sprayer.
  • Avoidance of irritants like smoke, pollution, allergens, or harsh chemicals.
  • Antibiotics or other medicine to treat infections. These may be taken as pills or gels applied to the nasal cavity.

Surgery may be needed if first line treatments cannot manage problems. Goals may include one or more of the following:

  • Clear crust or adhesions.
  • Temporarily block some nasal passages to let the lining of the nose heal.
  • Change the shape or size of small bones called turbinates. This will change airflow and may help some areas of lining heal.

Prevention

There are no known steps to prevent atrophic rhinitis.

RESOURCES

American Academy of Otolaryngology—Head and Neck Surgery  https://www.entnet.org 

Family Doctor—American Academy of Family Physicians  https://www.familydoctor.org 

CANADIAN RESOURCES

Canadian Society of Otolaryngology—Head and Neck Surgery  https://www.entcanada.org 

Health Canada  https://www.canada.ca 

References

Bist S, Bisht M, et al. Primary atrophic rhinitis: a clinical profile, microbiological and radiological study. ISRN Otolaryngol. 2012 Nov 19;2012:404075. Available at: https://www.hindawi.com/journals/isrn/2012/404075. Accessed March 12, 2021.

Mishra A, Kawatra R, et al. Interventions for atrophic rhinitis. Cochrane Database Syst Rev. 2012 Feb 15;(2):CD008280. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008280.pub2/abstract. Accessed March 12, 2021.

Moore EJ, Kern EB. Atrophic rhinitis: a review of 242 cases. Am J Rhinol. Nov-Dec 2001;15(6):355-361. Available at: https://pubmed.ncbi.nlm.nih.gov/11777241. Accessed March 12, 2021.

Non-allergic rhinitis. NHS website. Available at: https://www.nhs.uk/conditions/non-allergic-rhinitis. Accessed March 12, 2021.

Sreedharan S, Prasad V, et al. A clinical study on atrophic rhinitis, its management and surgical outcome. General Med 2015,3:1. Available at: https://www.longdom.org/open-access/a-clinical-study-on-atrophic-rhinitis-its-management-and-surgical-outcome-2327-5146.1000155.pdf. Accessed March 12, 2021.

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