Crusting in Atrophic Rhinitis: Why is there Crusting in Atrophic Rhinitis?

Question: Why is there crusting in atrophic rhinitis?

Answer:

Atrophic rhinitis is a chronic nasal condition in which the nose is unable to function as it should.  The nose and the nasal linings takes the air that we breathe and warms it to 98.6 degrees F and 100 percent humidity, by the time the air reaches the back of the nose.  However, sometimes the lining of the nose can become damaged and lose this function.  As a result, the air then tends to be dry and irritating.  With atrophic rhinitis, changes in the function of the nasal passages are caused by the mucosa (the tissue that lines the nose) and the underlying bone shrinking down, causing atrophy of the nasal passages. Typically this condition affects both of the nostrils and can be highly bothersome, even though this is not a life-threatening condition.

Atrophic rhinitis can cause crusting, sinus infections, and nosebleeds. Other common symptoms of atrophic rhinitis include:

  • Crusting (often green)
  • Nosebleeds
  • Nasal discharge
  • Nasal obstruction
  • Nasal deformity
  • Sore throat
  • Headaches
  • Bad breath
  • Strong odor from the nose
  • Watery eyes
  • Decreased/loss of smell
  • Frequent respiratory infections

Atrophic rhinitis can be caused by over-aggressive nasal surgery- especially when the inferior turbinates are removed, medication abuse (too much afrin/neosynephrine, cocaine use and certain infections). While the treatment is difficult, there are a variety of methods available to help treat atrophic rhinitis. Overall, the main goal of treatment consists of rehydrating and re-moisturizing the nasal lining to help alleviate the build-up of crust. The treatment for atrophic rhinitis is extensive and unfortunately, not always successful. In some cases, a variety of treatments are necessary, and they need to be ongoing. When treatment stops, the symptoms typically return.

I would speak to your sinus specialist about your care or visit us here at the NY Sinus Center.

Robert Pincus MD

Co-Director NY Sinus Center