Dictionary of Allergies .. Atrophic rhinitis

Mucosal atrophy can be the result of disease or aging. Usually is not recognized and is poorly described. Atrophy  increases the patency of the airway and reduces resistance to flow of air. This condition produces in some patients nasal congestion. In a few cases transpantation of cartilage in the nares can produce a degree of obstruction which results in subjective improvement. It has been  proposed by  Effat KG and Madany NM (2009) that the initial trigger for primary atrophic rhinitis is a virulent bacterial infection of the nasal lining, which leads to damage of the ciliated epithelium. This initiates the cascade of events leading to inflammation of the mucosa and submucosa, with secondary pyogenic osteomyelitis of the turbinate bone.

The persistence of purulent secretion, within the setting of impaired mucociliary clearance, leads to saprophytic fungal colonisation which contributes greatly to the clinical picture[1]. Jaswal A, et al (2008) in a  randomized control trial, performed at a tertiary referral hospital, compared the therapeutic effectiveness of two novel treatment modalities, oral rifampicin and submucosal placentrex injection, in randomly selected patients of primary atrophic rhinitis regarding objective, subjective and histopathological improvement. Patients treated with oral rifampicin showed most promising results regarding objective, subjective and histopathological improvement with maximum disease-free interval on regular follow-up as compared to submucosal placentrex injections[2].

References

1. Effat KG, Madany NM Microbiological study of role of fungi in primary atrophic rhinitis. J Laryngol Otol. 2009 Jun;123(6):631-4. Epub 2008 Oct 17.

2. Jaswal A, Jana AK, Sikder B, Nandi TK, Sadhukhan SK, Das A. Novel treatment of atrophic rhinitis: early results. Eur Arch Otorhinolaryngol. 2008 Oct;265(10):1211-7. Epub 2008 Mar 4