Atrophic rhinitis may be primary or secondary. Identifying the cause is important in planning management.


Causes of secondary atrophic rhinitis:

(1) advanced age (onset usually after the age of 40 years)

(2) surgery or trauma, especially with excessive removal of the turbinates

(3) nasal inhalation of cocaine or other drugs of abuse

(4) radiation

(5) chronic nasal infection (leprosy, syphilis, rhinoscleromatosis)

(6) chronic nasal inhalation of irritant chemicals


Pathophysiologic factors leading to atrophic rhinitis:

(1) destruction of nasal structures with a change in airflow

(2) excessive dryness of the nasal mucosa

(3) chronic inflammation with squamous metaplasia of the respiratory epithelium


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