Presentation
Chronic nasal discharge with fetid odour. No history of surgery.
Patient Data
The CT scan demonstrates:
bilateral atrophy of the superior, middle and inferior turbinates
resorption of the bony turbinates
enlarged nasal fossae with mild bowing of lateral nasal walls
Loss of definition of the ostiomeatal complex
hypoplasia of the paranasal sinuses with mucoperiosteal thickening
unilocular expansile cystic lesion of the maxilla arising in close relation to the tooth 23, probably a dentigerous cyst (incidental finding)
Case Discussion
Atrophic rhinitis, also called ozena or empty nose syndrome is a rare chronic disease characterised by a progressive atrophy of the nasal mucosa with resorption of the underlying cartilage/bone 1,2, usually seen in young women of a low socioeconomic level with unhygienic conditions 2,3.
It is caused by Klebsiella ozaenae 3. Often patients present with a history of chronic nasal discharge with a fetid odour which could progress to destruction of the nasal bones and anosmia in late stage 1. On imaging, the main features are 1,2,3:
atrophy of the turbinates as well as the bony turbinates
enlarged nasal cavities with bowing of the lateral nasal walls
hypoplasia of the paranasal sinuses with mucoperiosteal thickening
loss of definition of the ostiomeatal complex due to resorption of the uncinate process and ethmoid bulla
Additional contributor: Z.E Boudiaf, MD, CIM Aurès, Batna, Algeria
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