Ozena
Ozena (or fetid runny nose) is a progressive process of an atrophic nature, which is observed in the mucous membrane, as well as in the bone and cartilage tissue of the nose. This process is accompanied by secretions of a viscous secret, which immediately dries up in the crust. The latter is accompanied by a characteristic unpleasant smell.
The content of the article:
Manifestations of ozena
Atypical forms of ozena
Causes of ozena
Diagnosis of ozena
Complications of ozena
Treatment of ozena
Ozena
Clinically, ozena, as a rule, is manifested by frequent discharge from the nasal cavity, having a purulent odor and leading to the formation of permanent crusts in the nose. Another symptom of ozena is a partial or complete loss of sense of smell. Diagnostically, ozen can be detected by rhinoscopy, CT, pharyngoscopy and X-ray. Various bacteriological studies of nasal secretions are also carried out. For the treatment of this disease, various kinds of medications are usually used (doctors conduct antibiotic therapy, installation with nasal cavity washing, as well as physiotherapy). In more serious cases, surgical treatment of ozena is performed, during which the side wall of the nose is moved, implantation is performed using allo- or autografts.
Ozena as a disease has been known since ancient times. The first thing that was described were the symptoms, the treatment of ozena. Descriptions of symptoms are found in Hindu and Egyptian manuscripts compiled as early as 1000 BC. Today, this disease is not as common as 200 years ago and accounts for no more than 3% of all existing diseases of the nose or paranasal sinuses. Ozena usually affects people under the age of 40, and very often ozena occurs in children. According to statistics, ozen is more common in women. Interestingly, ozena has never been observed in representatives of the Negroid race, as well as in Arabs.
Today, specialists in the field of otolaryngology identify several main factors that are possible causes of the formation and development of this disease. Such factors include injuries to the nose, injuries to the bones of the facial skeleton, possible damage to the wing-palatine node, damage to the autonomic nerve trunks, as well as the trigeminal nerve. Interestingly, infectious diseases can also be possible causes of the formation and development of ozena. For example, rubella, measles, chickenpox, scarlet fever and diphtheria have repeatedly led to the development of ozena in children. Such chronic infectious foci as rhinitis, sinusitis, tonsillitis and pharyngitis can also become factors in the development of the disease. Bad habits, poor nutrition and unsatisfactory social and living conditions – all this in rare cases causes ozen.
Manifestations of ozena
In its development, ozen goes through three stages: the initial stage, the stage of the height and the final stage. Each of these stages has its own characteristic features.
The initial stage of ozena, as a rule, occurs at the age of 7. The disease begins very imperceptibly and develops slowly. After some time since the onset of ozena, parents may pay attention to the constant unnatural discharge from their child’s nasal cavity. Such secretions at first have a viscous nature, but after some time they become purulent with an unpleasant odor. A child with ozena may periodically experience sleep disorders, headaches unusual for children, weakness, decreased appetite and an increased degree of fatigue.
The initial stage of ozena is characterized by a slow but progressive course, which is very difficult to eliminate, even using the most advanced treatment methods. With the development of the disease, crusts begin to form in the child’s nose, and the smell of secretions becomes putrid. During puberty, this unpleasant smell coming from the nose of the child is even more amplified and is already audible to the surrounding people, but the child himself eventually ceases to feel it. The latter is associated with a violation of the olfactory receptors in the nasal cavity, as well as with the occurrence of hypoosmia.
At the stage of the height of the cold, full symptoms are expressed: the patient discovers in the nasal cavity a large number of crusts in the nose, which are also poorly removed from there, the patient feels labored nasal breathing, deals with constant discharge from the nasal cavity having a viscous consistency, as well as stuffiness and dryness in the nose. The main symptoms of ozena at the height stage also include a reduced degree of taste sensitivity and pain in the forehead and nose. Increased lethargy and fatigue are another characteristic symptoms. It should also be said that frequent nosebleeds are possible with ozen.
When examining a child suffering from ozena, the doctor, as a rule, reveals characteristic signs of underdevelopment of the facial skull, and first of all, the pyramid of the nose. With ozen, the child often has unnatural thickened lips, dilated nostrils and nasal passages. Interestingly, with ozen, a child may complain of difficulty in nasal breathing, although the nasal passages are in an expanded state. The latter is explained by a reduced level of sensitivity of tactile receptors, which normally perceive air circulation in the nasal cavity.
The final stage of ozena is often observed in people who have reached at least 40 years of age. At this stage, the nasal crusts characteristic of the first two stages are no longer formed, nasal secretions and the unpleasant odor associated with them also decrease or completely disappear. The final stage of ozena is often called self-healing of this disease. But anyway, after the final cure of ozena, the patient still has symptoms of chronic atrophic rhinitis, manifested by dry nose and anosmia.
Atypical forms of ozena
Usually, unilateral ozen occurs in patients who have a congenital curvature of the nasal septum, which causes one half of the nose to expand and the other to narrow. One-sided ozena has the same characteristics of its flow as the classic view. However, it is distinguished from the latter by the fact that it has the peculiarity of developing in the wide part of the nose.
If ozena localizes only in limited areas of the nasal cavity, then, as a rule, it occurs in the middle nasal passages. Very often localized ozen causes atrophy of the posterior parts of the middle nasal passages, while hypertrophy is observed in the anterior parts. Ozena, which has no crust, is not usually accompanied by viscous secretions. Whereas the presence of crusts leads to the appearance of an unpleasant smell.
Causes of ozena
Although ozena is an ancient disease, doctors have not yet established exactly its true etiology. Today, there are a great many theories that have appeared as doctors have established certain causes of the occurrence and development of ozena.
