Clinical features:
(1) chronic, bilateral rhinitis
(2) atrophy of the nasal mucosa and turbinates, with enlargement of the nasal passages
(3) presence of a foul-smelling mucopurulent discharge
(4) widespread crusting as the discharge dries out
(5) often concommitant paranasal sinusitis
(6) choking sensation if lesions extend into the nasopharynx
Risk factors:
(1) poor social conditions
(2) female gender
(3) after puberty
Possible contributory causes:
(1) infection with Klebsiella ozaenae or other bacteria
(2) endocrine imbalance
(3) autoimmune disease
Differential diagnosis - atrophic sinusitis secondary to another cause:
(1) radiation therapy
(2) excessive surgery or trauma
(3) chronic granulomatous inflammation