page 147 El Sevier, Diseases of Ear, Nose and Throat Fourth Edition
Treatment of Primary Atrophic Rhinitis
It may be medical or surgical
1. Medical. Complete cure of the disease is not yet possible. Treatment aims at maintaining nasal hygiene by removal of crusts and the associated putrefying smell, and to further check crust formation.
a) Nasal irrigation and removal of crusts. Warm normal saline or an alkaline solution made by dissolving a teaspoonful of powder containing soda bicarbonate 1 part. Sodium biborate 1 part, Sodium chloride 2 parts in 280 ml of water, is used to irrigate the nasal cavities. The solution is run through one nostril and comes out from the other. It loosens the crusts and removes thick tenacious discharge. Care should be taken to avoid pushing the fluid into the sinuses and eustachian tube. Initially, irrigations are done 2 or 3 times a day but later once every 2 or 3 days is sufficient. Hard crusts may be difficult to remove by irrigation. They are first loosened and then mechanically removed with forceps or suction.
b) 25% glucose in glycerine. After crusts are removed, nose is painted with 25% glucose in glycerine. This inhibits the growth of proteolytic organisms which are responsible for foul smell.
c) Local antibiotics. Spraying or painting the nose with appropriate antibiotics help to eliminate secondary infection. Kemicitine antiozaena solutions contains chloromycetin, oestradiol and vitamin D2 and may be found useful.
d) Oestradiol spray. Helps to increase vascularity of nasal mucosa and regeneration of seromucinous glands.
e) Placental extract injected submucosally in the nose may provide some relief.
f) Systemic use of streptomycin. 1g/day for 10 days has given good results in reducing crusting and odour. It is effective against Klebsiella organisms.
g) Potassium iodide given by the mouth promotes and liquifies nasal secretion.
2. Surgical. It includes:
(a) Young,s operation. Both the nostrils are closed completely just within the nasal vestibule by raising flaps. They are opened after 6 months or later. In these cases, mucosa may revert to normal and crusting reduced.
Modified Young's operation. To avoid the doscomfort of bilateral nasal obstruction, modified Young's operation aims to partially close the nostrils. It is also claimed to give the same benefits as Young's.
(b) Narrowing of the nasal cavities. Nasal chambers are very wide in atrophic rhinitis and air currents dry up secretions leading to crusting. Narrowing the size of the nasal airway helps to relieve the symptoms. Among the techniques followed, some are :
(1) Submucosal injection to teflon paste
(2) Insertion of fat, cartilage bone or teflon strips under the mucoperiosteum of the floor and lateral wall of nose and the mucoperichondrium of the septum.
(3) Section and medial displacement of lateral wall of nose.
Jalalluddin Sayuti April 1 at 3:35pm Report
http://en.wikipedia.org/wiki/Chronic_atrophic_rhinitisTreatment of Primary Atrophic Rhinitis
It may be medical or surgical
1. Medical. Complete cure of the disease is not yet possible. Treatment aims at maintaining nasal hygiene by removal of crusts and the associated putrefying smell, and to further check crust formation.
a) Nasal irrigation and removal of crusts. Warm normal saline or an alkaline solution made by dissolving a teaspoonful of powder containing soda bicarbonate 1 part. Sodium biborate 1 part, Sodium chloride 2 parts in 280 ml of water, is used to irrigate the nasal cavities. The solution is run through one nostril and comes out from the other. It loosens the crusts and removes thick tenacious discharge. Care should be taken to avoid pushing the fluid into the sinuses and eustachian tube. Initially, irrigations are done 2 or 3 times a day but later once every 2 or 3 days is sufficient. Hard crusts may be difficult to remove by irrigation. They are first loosened and then mechanically removed with forceps or suction.
b) 25% glucose in glycerine. After crusts are removed, nose is painted with 25% glucose in glycerine. This inhibits the growth of proteolytic organisms which are responsible for foul smell.
c) Local antibiotics. Spraying or painting the nose with appropriate antibiotics help to eliminate secondary infection. Kemicitine antiozaena solutions contains chloromycetin, oestradiol and vitamin D2 and may be found useful.
d) Oestradiol spray. Helps to increase vascularity of nasal mucosa and regeneration of seromucinous glands.
e) Placental extract injected submucosally in the nose may provide some relief.
f) Systemic use of streptomycin. 1g/day for 10 days has given good results in reducing crusting and odour. It is effective against Klebsiella organisms.
g) Potassium iodide given by the mouth promotes and liquifies nasal secretion.
2. Surgical. It includes:
(a) Young,s operation. Both the nostrils are closed completely just within the nasal vestibule by raising flaps. They are opened after 6 months or later. In these cases, mucosa may revert to normal and crusting reduced.
Modified Young's operation. To avoid the doscomfort of bilateral nasal obstruction, modified Young's operation aims to partially close the nostrils. It is also claimed to give the same benefits as Young's.
(b) Narrowing of the nasal cavities. Nasal chambers are very wide in atrophic rhinitis and air currents dry up secretions leading to crusting. Narrowing the size of the nasal airway helps to relieve the symptoms. Among the techniques followed, some are :
(1) Submucosal injection to teflon paste
(2) Insertion of fat, cartilage bone or teflon strips under the mucoperiosteum of the floor and lateral wall of nose and the mucoperichondrium of the septum.
(3) Section and medial displacement of lateral wall of nose.
Jalalluddin Sayuti April 1 at 3:35pm Report
http://www.ehow.com/way_5391056_atrophic-rhinitis-treatment.html
http://www.aaaai.org/professionals/resources/pdf/rhinitis2008.pdf
http://journals.tubitak.gov.tr/medical/issues/sag-03-33-6/sag-33-6-12-0307-11.pdf
http://www.utmb.edu/otoref/grnds/Atrophic-Rhinitis-050330/Atrophic-Rhinitis-050330.htm
http://www.waent.org/archives/2010/Vol3-2/20100910-atrophic-rhinitis/atrophic-rhinitis-manuscript.htm
where can I find the 25% glycerine and glucose to clean out my nose after rinses?
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