Computed tomographic findings in atrophic rhinitis.
Computed tomography (CT) has been used increasingly in the assessment of patients with symptoms of sinonasal disease since the introduction of functional endoscopic surgery for the treatment of chronic sinusitis. The association of sinusitis and atrophic rhinitis will inevitably lead to more frequent imaging of patients with atrophic rhinitis. Correct interpretation of the CT appearances of atrophic rhinitis is important as misinterpretation may have serious implications during sinus surgery. These appearances have not been described previously. We describe and discuss the CT findings in three patients with clinical evidence of atrophic rhinitis.
Available from: Mark Erik Friedel
- "Bony resorption or destruction of the middle and inferior turbinates with atrophic thinning of mucosa was seen on all studies as well.2 These findings were found to be consistent with a prior review by Pace-Balzan et al., which coined the term “empty nose syndrome” to describe the vast changes to the anatomy of ozena patients on CT imaging.3 "
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ABSTRACT: Ozena, which is often used interchangeably with atrophic rhinitis or empty nose syndrome, is a progressive and chronically debilitating nasal disease that results in atrophy of the nasal mucosa, nasal crusting, fetor, and destruction of submucosal structures. Although the etiology is not completely understood, infection with Klebsiella ozaenae is widely believed to contribute to the destructive changes. We present a case of a patient with ozena secondary to K. ozaenae with extensive destruction of bony structures of the nasal cavity undergoing elective dacryocystorhinostomy. An extensively thinned skull base secondary to the disease process resulted in an unforeseen complication in which the skull base was entered leading to a cerebrospinal fluid leak. Patients with known history of ozena or atrophic rhinitis often have extensive destruction of the lateral nasal wall and skull base secondary to progression of disease. Submucosal destruction of these bony structures mandates the need for extreme caution when planning on performing endoscopic intervention at or near the skull base. If physical examination or nasal endoscopy is suspicious for atrophic rhinitis or a patient has a known history of infection with K. ozaenae, we recommend preoperative imaging for surgical planning with careful attention to skull base anatomy.
04/2011; 2(1):36-9. DOI:10.2500/ar.2011.2.0007
Otolaryngology Head and Neck Surgery 05/1997; 116(4):554-8. DOI:10.1016/S0194-5998(97)70311-5 · 2.02 Impact Factor
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ABSTRACT: A total of 29 atrophic rhinitis patients were treated by endoscopic sinus surgery between 1990 and 1995. After the surgery, a 7 to 10-day course of systematic aminoglycoside was administered. Two cases were excluded, due to later occurrence of nasal lymphoma in one patient and incompleteness of postoperative antibiotic therapy in the other. Among those included, atrophic rhinitis occurred in the absence of prior surgery in 24 patients, and the condition was secondary to a previous intranasal surgery in the other three patients. After a 1 to 6-year follow-up (mean: 63.4 months), seven patients were successfully managed without any characteristic symptom or sign of atrophic rhinitis. Another 18 patients felt improved. Only two patients did not have any improvement. The rate of improvement was 92.6%. Overall, one patient suffered from a left retrobulbar hematoma after operation. Exposed orbital fat was observed in the other patient. The orbital complication rate was therefore 7.4%. No other major complication occurred in this series. The bacteriologic, radiological, antroscopic, and pathologic findings are also included here. It is concluded that endoscopic sinus surgery in combination with adequate postoperative antibiotic therapy can significantly treat atrophic rhinitis.
American Journal of Rhinology 08/1998; 12(5):325-33. DOI:10.2500/105065898780182480 · 1.36 Impact Factor
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