Atrophic rhinitis

Discussion:

Atrophic rhinitis, also called ozena or empty nose syndrome is a rare chronic disease characterized 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 odor 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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