Atrophic rhinitis

For a lay person:

Atrophic rhinitis is a long-term condition in which the lining of the nose thins and dries out, forming thick crusts that often smell unpleasant. It can occur on its own or follow nasal surgery, injury or radiotherapy, and it causes nasal blockage, crusting and loss of smell.

For a trained medical person:

Primary atrophic rhinitis (ozaena) is associated with Klebsiella ozaenae and other bacterial colonisation; secondary forms follow extensive turbinate or sinus surgery, radiotherapy, trauma or granulomatous disease. Diagnosis is by nasal endoscopy showing a roomy cavity with atrophic mucosa and crusting. Management is regular saline douching, crust removal, emollients, topical antibiotics for infection and occasionally surgery to narrow the nasal cavity.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Yin Deficiency and Lung Dryness; Spleen and Stomach Deficiency; Kidney Yin Deficiency. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: See a doctor for repeated or heavy nosebleeds, facial pain or swelling, or nasal symptoms after surgery or radiotherapy, so that other causes such as granulomatous disease can be excluded.