DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20181993

Clinicopathological study of atrophic rhinitis

Rehana E., G. Priyadarshini, Ayisha Kunnumal

Abstract


Background: Atrophic rhinitis is a chronic nasal disease characterized by progressive atrophy of mucosa and underlying bone of turbinate’s.1 Disease is also referred to as dry rhinitis, rhinitis sicca, open-nose syndrome, or ozena. It is classified into 2 types viz., primary and secondary. The cause of primary atrophic rhinitis is unknown. Histopathologically, primary atrophic rhinitis is characterized by squamous metaplasia and two characteristic types of vascular involvement (Type I and Type II). Type I is common (50-80%) where endarteritis obliterans, periarteritis and periarterial fibrosis of the terminal arterioles is seen. These patients benefit from the oestrogen therapy. Type-II is less common (20-50%) and is associated with capillary vasodilatation

Methods: This study was carried out in the Department of Otorhinolaryngology, Aarupadai Veedu Medical College and hospital, Puducherry between October 2015 and July 2017.51 patients of atrophic rhinitis of age 12 years to 95 years were included. Detailed history and complete ENT examination was done in all patients.  

Results: In the present study atrophic rhinitis cases formed 0.34% of the total OPD attendance. Maximum number of patients belonged to the age group of 51-60 years (33.3%) followed by 61-70 years (27.5%). Disease was found to be more common in females (82.4%) female to male ratio was 4.7:1. Most common complaint of the patients was nasal crusting (96.1%) followed by nasal fetor (92.2). In present study, most of the patients had chronic symptoms for the past 1-5 years (45.1%) and 6-10 years (29.4%). 35 patients i.e. 68.6% showed bilateral atrophic rhinitis and 16 patients i.e. 31.4% showed unilateral atrophic rhinitis. In the present study, majority of patients belong to class V of Modified B G Prasad scale (47.1%). Severity of the disease was classified into 3 stages, that is, early, advanced, and late advanced, according to the findings in the nasal cavity as recommended by Ssali. The majority of patients 36 (70.5%) were in the advanced stage. Partial squamous metaplasia and total squamous metaplasia, were seen in 35.7% and 42.9% of patients respectively, denuded epithelium were noted in 9 patients i.e. 21.4%.

Conclusions: Incidence of atrophic rhinitis is in a decreasing trend. Females and people of age group 51-60 years are commonly affected. Bilateral atrophic rhinitis is more common. Lower socioeconomic status is a predisposing factor due to hygiene issues. Our institution being a tertiary care centre most patients presented with advanced stage of disease. Total squamous metaplasia is the commonest histological finding in patients with atrophic rhinitis.

 


Keywords


Atrophic rhinitis, Ozaena

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References


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