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  • 1. ATROPHIC RHINITISMEGHA.V 4061

2. CONTENTS: DEFINITION HISTORY ETIOLOGY PATHOLOGY SYMPTOMS & SIGNS RADIOLOGICAL FINDINGS COMPLICATIONS DIFFERENTIAL DIAGNOSIS TREATMENT 3. DEFINITION CHRONIC INFLAMMATORY DISEASE ATROPHY 4. HISTORY Dr. Spencer Watson(1875) Dr. Bernhard Fraenkel(1876) : TRIAD of atrophyfetorcrusts 5. Synonyms: OZAENA MERCIFUL ANOSMIA DRY RHINITIS 6. ETIOLOGICAL TYPESPRIMARY ATROPHIC RHINITIS SECONDARY ATROPHIC RHINITIS 7. CAUSES OF PRIMARY ATROPHIC RHINITISHERNIA 8. HERNIA HEREDITY 9. HERNIA ENDOCRINAL DISTURBANCE 10. HERNIA RACIAL FACTORS 11. HERNIA NUTRIONAL DEFICIENCY 12. HERNIA INFECTIVE 13. HERNIA AUTOIMMUNE PROCESS 14. SECONDARY ATROPHIC RHINITIS 1. Chronic specific infectionsLupus vulgaris syphilis leprosy 15. SECONDARY ATROPHIC RHINITIS 2. Extensive surgery of the nose (turbinectomy) 16. SECONDARY ATROPHIC RHINITIS 3. Severe deviated nasal septum 17. PATHOLOGY: Microscopic changesNORMAL 18. squamous metaplasiaAbsence of ciliaAtrophy of muscosal glands 19. NormalAtrophy of nerve endings and olfactory nerve 20. Why nasal obstruction even in the presence of roomy nasal cavity? 21. Why nasal obstruction even in the presence of roomy nasal cavity?PARADOXICAL NASAL OBSTRUCTION 22. SIGNS : EXTERNAL NOSE: 23. SIGNS : ANTERIOR RHINOSCOPY: ATROPHIED TURBINATESGREENISH FOUL SMELLING CRUSTSPALE & ATROPHIC MUCOSA 24. Radiological findings : Mucoperiosteal thickening of paranasal sinuses Loss of definition of osteomeatal complex Enlargement of nasal cavity with erosion and bowing of the lateral nasal wall Atrophy of inferior and middle turbinates hypoplastic maxillary sinuses 25. Differential diagnosis 26. Differential diagnosis 27. Differential diagnosis 28. TREATMENT MEDICAL THERAPY - LOCAL SYSTEMIC SURGICAL THERAPY 29. ALKALINE NASAL DOUCHE 30. Sodium biborate (28.4 g) Sodium carbonate (28.4 g) Sodium chloride (56.7 g)mixed in 280 ml of luke warm water. 31. Nasal drops 25% glucose in glycerine Chloramphenicol & streptomycin drops oetradiol spray 32. Kemicetine(local antibiotic) 33. Placental Extracts 34. Potassium iodide 35. Systemic : Streptomycin (1 g/day) Vitamin A Vasodilators 36. Surgical : Youngs operation Modified youngs operation Wilsons procedure Whitmaacks operation Other volume reduction procedures Denervating operations 37. Youngs operation 38. Modified Youngs operation 39. Quick note for treatment of atrophic rhinitisATROPI In Young Girls A- antibiotic spray T- teflon paste R- remove crust O- oetradiol therapy P-potassium iodide ,placental extracts I- irrigation In- insertion of fat,cartilage Y- youngs operation G-glucose in glycerine Girls- (more in females) 40. References : A short book of E.N.T (K.B.bhargava), 9th edition,atrophic rhinitis,pg 158. Diseases of E.N.T ,P.L.Dhingra,5th edition http://www.drtbalu.co.in/atro_rhinitis.html http://www.utmb.edu/otoref/grnds/Atrophic-R hinitis-050330/Atrophic-Rhinitis-050330.htm