What Is Atrophic Rhinitis and How To Treat It

Atrophic rhinitis, also known as ozaena, is a nasal condition where the mucus lining, blood vessels, bones, and nerve endings in the nose deteriorate, i.e. they waste away or become ‘atrophied’. As this happens, the tissues dry out and harden. As a result, the nasal passages widen and become encrusted.

Most people don’t realize how important the nose is to our overall health. When the nose is functioning normally, the mucus in the nose traps bacteria, viruses, and other foreign substances and then pushes them to the stomach where the stomach acid destroys them. When the nasal mucus membrane stops functioning in this way, infections throughout the whole body become more common because that first line of defense is missing. The nose also functions to warm and moisturize the air we breathe before it hits the lungs. If this doesn’t happen properly, the respiratory system may be compromised.

Symptoms of atrophic rhinitis

This condition is most commonly characterized by a crusty nose, which can sometimes affect one’s ability to breathe properly. A strong foul odor can sometimes emanate from the nose due to ongoing infections. Nosebleeds, often severe, can also be common. As the condition worsens, some people experience a loss of smell (anosmia). In extreme cases, atrophic rhinitis can cause severe deformities of the nose. In rare cases, the destruction of tissues can extend into the membranes surrounding the brain and into the brain itself. Normally, atrophic rhinitis is not life threatening, but in these rare instances, it can become so.

What exactly causes this condition

The exact cause of this type of rhinitis often remains a mystery, even to an experienced otolaryngologist (ear, nose, and throat doctor). However, in other cases, the doctor may be able to determine the cause through a bit of detective work. For example, the doctor may order a culture of the crust in the nose to determine if the cause is infection, and if so, the specific bacteria or fungi causing the infection. Atrophic rhinitis also seems to be hereditary as it does run in families. Hormonal imbalances are also suspected to cause this condition in some cases.

Who gets this condition

Atrophic rhinitis occurs more often as people get older. It can be associated with an infection in the blood vessels called granulomatosis with polyangiitis. This type of rhinitis can also develop sometimes in people who have had part of their nasal mucous membranes or other nasal structures removed during sinus surgery.

What is chronic atrophic rhinitis

This is another name for the same condition. The term ‘chronic’ is sometimes added to the name to indicate it is an ongoing condition that may get progressively worse without intervention.

Treatment for atrophic rhinitis

The goals for the treatments of atrophic rhinitis focus on eliminating the crust, moisturizing the nose, regaining function of the nose, and eliminating the odor if present. Sterilized saline solutions are used to clean out the nose. Antibacterial salves are used to reduce infections and moisturize the membranes of the nose. Estrogens sprays are sometimes used as well if there is a suspected hormonal cause. Taking vitamin A, vitamin D, and iron can help as well because deficiencies in these minerals can cause or exacerbate the condition. In some cases, surgery is performed to narrow the nasal cavities and restore function to the mucus membrane.

If the doctor is able to determine the exact cause, then more treatment options become available for the condition. For example, if the nose culture shows an infection of a specific bacterial species, such as Proteus vulgaris or Klebsiella ozaenae, then the doctor can prescribe antibiotic ointments or rinses that can target that specific infectious organism and kill it. If the infection is really severe, the doctor may prescribe a round of oral antibiotics as well to knock it out faster.

Home remedies for atrophic rhinitis

Home humidifiers can help to keep the nose from drying out so much, especially during the hotter and or less humid months of the year. Using a neti pot on a regular basis to rinse out the debris in the nose can also be helpful. Breathing the fumes from freshly diced garlic seems to help some people as garlic has very strong antibacterial properties. Some people with severe atrophic rhinitis and who also live in dry climates may want to consider moving to a more humid region of the country to help keep the nose moist. This may also be a consideration when planning a vacation.