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
Frequently Asked Questions
Crusting in atrophic rhinitis occurs because the nasal mucosa and underlying bone shrink and atrophy, leading to a dry and irritated nasal lining. This dryness causes thick mucus to accumulate and harden, resulting in crust formation inside the nose.
Atrophic rhinitis commonly presents with symptoms such as green crusting inside the nose, nosebleeds, nasal discharge, nasal obstruction, nasal deformity, sore throat, headaches, bad breath, a strong odor from the nose, watery eyes, loss or decrease in smell, and frequent respiratory infections.
Atrophic rhinitis can be caused by over-aggressive nasal surgeries, especially those involving removal of the inferior turbinates, medication abuse such as excessive use of nasal sprays like Afrin or Neosynephrine, cocaine use, and certain infections.
Treatment focuses on rehydrating and moisturizing the nasal lining to alleviate crust build-up. Various methods may be used, often requiring ongoing care because symptoms typically return when treatment stops. Complete cure is challenging, and multiple treatments might be necessary.
No, atrophic rhinitis is not life-threatening. However, it can cause bothersome symptoms like crusting, nosebleeds, and nasal obstruction that significantly affect quality of life.
The nasal lining loses its function in atrophic rhinitis because the mucosa and underlying bone atrophy or shrink, impairing the nose’s ability to warm, humidify, and filter the air effectively, which leads to dry and irritating airflow.
Yes, atrophic rhinitis can lead to a strong, unpleasant odor emanating from the nose due to crusting and accumulation of dried mucus and debris in the nasal passages.
