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Atrophic rhinosinusitis

Richard D deShazo, MD
Scott Stringer, MD
Section Editor
Jonathan Corren, MD
Deputy Editor
Anna M Feldweg, MD


Atrophic rhinitis is an uncommon and distinct clinical syndrome of progressive atrophy of the nasal mucosa. It is characterized by paradoxical nasal congestion and thick, troublesome nasal secretions and complicated by bacterial colonization and infection. Enlargement of the nasal cavities may occur in some forms. Most patients also have concomitant sinusitis, and thus, the disorder is more accurately called atrophic rhinosinusitis. There are primary and secondary forms of this disorder, which affect different populations and have distinct presentations.

This topic will discuss the classification, clinical manifestations, diagnosis, and management of atrophic rhinosinusitis. Other forms of chronic rhinosinusitis are reviewed separately. (See "Chronic rhinosinusitis: Clinical manifestations, pathophysiology, and diagnosis" and "Chronic rhinosinusitis: Management".)


Atrophic rhinosinusitis may be categorized into two forms: primary (or idiopathic) and secondary.

The primary form is seen primarily in young people in the developing world. It is associated with mucosal colonization, predominantly with Klebsiella ozaenae as well as other organisms. The primary presenting symptom is foul-smelling nasal discharge.

Secondary atrophic rhinosinusitis is seen with some regularity in the developed world and occurs in patients who underwent prior sinonasal trauma, surgery, radiation therapy, or have certain inflammatory conditions (granulomatous diseases).

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Literature review current through: Nov 2017. | This topic last updated: Oct 25, 2016.
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