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Atrophic Rhinitis: Causes and Pathology

Atrophic rhinitis is a chronic inflammation of the nose characterized by atrophy of the nasal mucosa and turbinate bones. It has two types: primary and secondary. Primary atrophic rhinitis has hereditary, endocrinal, racial, nutritional, infective, and autoimmune causes. It results in loss of ciliated epithelium and atrophy of structures in the nose. Secondary atrophic rhinitis can be caused by infections like syphilis or treatments like radiation or excessive turbinate removal. Unilateral atrophic rhinitis may occur due to nasal septum deviation.

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35 views11 pages

Atrophic Rhinitis: Causes and Pathology

Atrophic rhinitis is a chronic inflammation of the nose characterized by atrophy of the nasal mucosa and turbinate bones. It has two types: primary and secondary. Primary atrophic rhinitis has hereditary, endocrinal, racial, nutritional, infective, and autoimmune causes. It results in loss of ciliated epithelium and atrophy of structures in the nose. Secondary atrophic rhinitis can be caused by infections like syphilis or treatments like radiation or excessive turbinate removal. Unilateral atrophic rhinitis may occur due to nasal septum deviation.

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kiruthiga.s
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© All Rights Reserved
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ATROPHIC RHINITIS

BY HARINI.N.K
ROLL NO: 41
DEFINITION
• IT IS A CHRONIC INFLAMMATION OF NOSE
CHARACTERISED BY ATROPHY OF NASAL
MUCOSA AND THE TURBINATE BONES
• THE NASAL CAVITIES ARE ROOMY AND
FULL OF FOUL SMELLING CRUSTS
TYPES
PRIMARY
SECONDA
RY
PRIMARY ATROPHIC RHINITIS
ETIOLOGY (MNEMONIC - HERNIA)
 HEREDITARY FACTOR
DISEASE IS KNOWN TO INVOLVE MORE THAN ONE MEMBER IN THE SAME
FAMILY
 ENDOCRINAL DISTURBANCE
DISEASE USUALLY STARTS UP AT PUBERTY
INVOLVES FEMALES MORE THAN MALES
CRUSTING & FOETOR ASSOCIATED WITH DISEASE TENDS TO CEASE AFTER
MENOPAUSE , THESE FACTORS HAVE RAISED THE POSSIBILITY OF DISEASE
BEING AN ENDOCRINAL DISORDER
 RACIAL FACTORS
WHITE & YELLOW RACES ARE MORE SUSCEPTIBLE THAN NATIVES OF
EQUATORIAL AFRICA
 NUTRITIONAL DEFICIENCY
DISEASE MAYBE DUE TO DEFICIENCY OF VITAMIN A,D OR IRON OR
SOMEOTHER DIETRY FACTORS
THE FACT THAT INCIDENCE OF DISEASE IS DECREASING IN WESTERN
COUNTRIES & IS RARELY SEEN IN WELL TO DO FAMILIES RAISES THE
POSSIBILITY OF SOME NUTRITIONAL DEFICIENCIES
INFECTIVE
VARIOUS ORGANISM HAVE BEEN CULTURED FROM CASES OF ATROPHYIC
RHINITIS SUCH AS KLEBSIELLA OZAENAE {MOST COMMON ALSO
KNOWN AS PEREZ BACILLUS}, DIPTHEROIDS, PROTEOUS MIRABILLUS,
[Link], STAPHLYCOCCI AND STREPHTOCOCCI THEY ARE ALL CONSIDER
TO BE SECONDARY INVADERS RESPONSIBLE FOR FOUL SMELLING
RATHER THA PRIMARY CAUSATIVE ORGANISM OF THE DISEASE
 AUTOIMMUNE PROCESS
THE BODY REACTS BY A DESTRUCTIVE PROCESS TO THE ANTIGENS
RELEASED FROM THE NASAL [Link] INFECTION OR
SOMEOTHER UNSPECIFIED AGENTS MAY TRIGGER ANTIGENICITY OF
NASAL MUCOSA.
PATHOLOGY
• CILIATED COLUMNAR EPITHELIUM IS LOST AND IS REPLACED BY STRATIFIED
SQUAMOUS TYPE.
• THERE IS ATROPHY OF SEROMUCINOUS GLANDS,VENOUS BLOOD SINUSOIDS
AND NERVE ELEMENTS
• ARTERIES IN MUCOSA ,PERIOSTEUM AND BONE SHOW OBLITERATIVE
ENDARTERITIS
• THE BONE OF TURBINATES UNDERGOES RESORPTION CAUSING WIDENING OF
NASAL CHAMBERS.
• PARANASAL SINUSES ARE SMALL DUE TO THEIR ARRESTED DEVELOPMENT.
SECONDARY ATROPHIC RHINITIS

• SPECIFIC INFECTIONS LIKE SYPHILIS , LUPUS, LEPROSY,


RHINOSCLEROMA MAY CAUSE DESTRUCTION OF THE NASAL
STRUCTURES LEADING TO ATROPHIC CHANGES.
• ATROPHIC RHINITIS CAN ALSO RESULT FROM LONG STANDING
PURULENT SINUSITIS AND RADIOTHERAPY TO NOSE AND SINUSES.
• EXCESSIVE SURGICAL REMOVAL OF TURBINATES CAUSES WIDE
NASAL CAVITY CALLED ‘ THE SYNDROME OF EMPTY NOSE’
UNILATERAL ATROPHIC RHINITIS

EXTREME DEVIATION OF NASAL SEPTUM MAYBE


ACCOMPANIED BY ATROPHIC RHINITIS ON THE WIDER SIDE.
EVERYONE UNDERSTOOD ?

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