Atrophic rhinitis is characterised by squamous metaplasia followed by atrophy. The nose becomes filled with foul smelling crusts. The smell from these crusts may cause the child to be ostracized.
The cause of atrophic rhinitis is unknown; it is uncommon in Western societies. The condition may follow radical nasal surgery, may be the end point of rhinitis medicamentosa, or may be due to chronic infective with specific organisms. Klebsiella is often cultured in this condition.
In the early stages of the disease meticulous attention to sinusitis and nasal hygiene may be useful. In the later stages nasal drops - glucose 50% in glycerine - may help to reduce the smell and crusting.
Surgical treatment involves closure of the nostrils using a circumferential flap of vestibular skin. Recovery of the nasal mucosa may occur after a period of prolonged closure and the nose can be reopened.
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