Ozaena

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The ozaena (from ancient Greek ὄξαινα óxaina "foul smelling nasal polyp" or ὂζειν ózein "smell, stink", Latinized in technical terms), also called rhinitis atrophicans cum foetore or "smelly nose" , is a rare disease of the nasal mucosa .

A distinction is made between two types of ozaena:

  1. The primary ozaena: does not occur as a result of other diseases and is probably hereditary
  2. The secondary ozaena: arises from external influences such as operations or diseases

The main characteristic of the disease is the atrophy of the nasal mucous membrane with the associated colonization of bacteria and strong odor development.

causes

The causes of the primary ozaena are unclear, but a genetic predisposition is suspected. It mostly affects women and girls from puberty onwards . There is also a familial accumulation of cases of the disease.
The secondary ozaena results from externally caused shrinkage of the nasal mucosa or an enlargement of the nasal cavity . Possible causes for this are:

Symptoms

The main symptom of ozaena is an unpleasant odor that the affected nose exudes and from which the name "stinky nose" comes. This is caused by the regression of the mucous membranes, as a result of which germs or bacteria can settle in the nose and form a greasy coating. The typical smell is perceived as extremely unpleasant and is often described as sweet or putrid.

The mucous glands in the nose are also affected by the atrophy. As a result, the inside of the nose dries out increasingly and strong crusts form. These are usually black to yellowish-green in color and can hinder nasal breathing. In addition, the peeling of the bark can cause nosebleeds.

The atrophy also affects the olfactory nerves, which is why those affected often lose their sense of smell and sometimes also their sense of taste. Due to the anosmia (lack of sense of smell or loss of the sense of smell) they do not perceive the smell from their nose themselves.

The following symptoms are also associated with an ozaena: headache and nose pain, suppuration. In severe cases, the bony structure of the turbinate can also recede.

diagnosis

A specialist in ENT ( ear, nose and throat medicine ) is responsible for diagnosing an ozaena . He usually recognizes the disease by the characteristic smell. With a rhinoscope he can also examine the condition of the nasal mucosa and inspect the formation of crusts and other changes. With the help of a smear or a tissue sample, a specialist can also determine exactly what type of bacteria it is. This can be helpful in treating ozaena.

treatment

A complete healing of the ozaena is often not possible, especially in the case of a genetic predisposition. However, the symptoms and discomfort can be significantly alleviated.

Treatment options on the part of the specialist:

  • Removal of the bark or crust
  • Suction of secretions or pus
  • surgery

There are two treatment approaches for a nose operation: If the atrophy of the bony nasal structure has led to an enlarged nasal cavity, the doctor can insert a small piece of cartilage . This reduces the free space in which bacteria can settle. The doctor can place an artificial channel between the nasal and oral cavities to prevent the nasal mucous membrane from drying out . As a result, saliva runs into the nose and moisturizes the dry mucous membranes.

The patient can also contribute to the treatment of the ozaena. First and foremost, it is important to keep the nasal lining moist. Helps:

In addition, vitamin A and vitamin E as well as zinc can have a positive effect on the regeneration of the nasal mucous membranes. Appropriate preparations can be taken in consultation with the attending physician.

literature

  • Hans Behrbohm, Oliver Kaschke, Tadeus Nawka: Short textbook ear, nose and throat medicine. 2nd, corrected and updated edition. Georg Thieme Verlag, Stuttgart 2012.
  • various authors: Pschyrembel. Clinical Dictionary. 260th, revised edition. Walter de Gruyter, Berlin 2004.

Individual evidence

  1. ↑ Wolfgang Legrum: Fragrances, between stink and fragrance , Vieweg + Teubner Verlag (2011) p. 65, ISBN 978-3-8348-1245-2 .

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