This is a disease that is accompanied by severe atrophic processes in the nasal cavity.

With the development of the disease, these processes affect the mucous membrane, the walls of the nasal cavity and nasal concha.

The tissues of the nose no longer receive enough nutrition, as a result of which they become thinner and cease to function normally.

Course of the disease

Ozena develops over three stages and each has its own characteristics:

Prevalence

Ozena is a fairly rare disease. Of all diseases of the nose, ozena accounts for approximately 3%. Most often, this disease affects people under the age of 40-50 years, most of whom are children.

Women are much more likely to get ozena than men. This disease is characteristic only for representatives of the white race and Asians.

Risk factors

There are a number of factors that can contribute to the development of an ozena:

Causes

Until now, the exact causes of this disease have not been established. According to one version, ozena occurs due to insufficient development of the paranasal sinuses, congenital changes in the structure of the nose and other physiological features of the body.

According to another version, ozena occurs when the nasal mucosa breaks down, or due to a lack of necessary nutrients in the bone tissues of the nose.

It has been definitely revealed that ozena is an infectious disease, since in people suffering from it, the nasal cavity contains a huge number of various microorganisms.

The most realistic theory is that ozena develops as a result of disturbances in the functioning of the nervous system - in particular, destruction of the pterygopalatine node.

Symptoms

Due to the many crusts in the nose, the patient may feel the presence of a foreign object in the nasal cavity. You can get rid of these crusts by blowing your nose, or by mechanically removing them from the nose.

Sometimes the patient has a decrease in taste sensitivity, and sometimes hearing loss associated with inflammatory processes in the middle ear. The patient may experience tinnitus.

Sometimes ozena spreads to nearby mucous membranes - the pharynx, larynx or trachea. This can lead to difficulty breathing, wheezing, and a dry throat.

Diagnostics

Diagnosis of ozena is carried out on the basis of the patient's complaints related to the signs of the disease, as well as his medical history. The doctor should analyze not only the history of the disease, but also the factors of the patient's predisposition to this disease - to find out about cases of ozena in relatives, nose injuries, physiological features of the structure of the nasal septum and other factors contributing to the development of ozena.

After that, it is carried out rhinoscopy, in which the nasal cavity of the patient is examined. Next is carried out pharyngoscopy- determination of the prevalence of the disease in adjacent areas of the throat. A smear is taken from the mucous membrane, which reveals the presence of Abel's sticks.

The final stage of diagnosis is a laboratory study of crusts from the nose.

Treatment

Conservative treatment and drugs

This type of treatment involves the removal of crusts from the nasal cavity, moisturizing and deodorizing. The patient is prescribed nasal lavage with hydrogen peroxide, a solution of potassium permanganate, or saline. Irrigation is carried out using a special nasal spray to prevent liquid from entering the auditory tube.

Tamponade Goldstein- often used in the treatment of this disease. This is a procedure in which a gauze swab with a solution of glycerin and iodine applied to it is inserted into the nasal cavity. After a few hours, this tampon is removed along with the softened crusts.

Ozena is sometimes treated with chlorophyllocarotene paste, introducing suppositories with this paste into the sinuses every day for a month. This procedure helps to eliminate the stench from the nose.

Significant improvement can be by inhaling ionized air and also after diathermy procedures.

A patient with ozena is often prescribed the following drugs: furazolidone, furagin, furatsilin, biogenic stimulants, sedatives, as well as a course of multivitamins and preparations containing iron.

Surgical

Surgical intervention is carried out with physiological disorders in the structure of the nose in a patient with ozena. The purpose of this operation is to narrow the nasal cavity, carried out by inserting the implant into the tissue located behind the mucous membrane.

After such a procedure, connective tissue begins to actively form, which leads to a narrowing of the nasal cavity.

As an implant, a special ivalon material. During surgery, the patient is injected with hormones that accelerate the growth of connective tissue and improve the development of blood vessels.

In difficult cases, a more radical operation is performed, in which the wall of the maxillary sinus is pressed against the nasal septum, after which it is fixed with a swab. As a result of this procedure, the nasal concha is fused with the nasal septum.

Folk methods

Some folk remedies help to alleviate the patient's condition with lakes, and sometimes completely recover:

Prevention

Some measures will reduce the risk of ozena disease:

• timely treatment of infectious diseases of the nose;
• balanced diet. Mandatory presence in the diet of foods that contain a lot of fiber;
• avoid injuries to the nose and face;
• get rid of bad habits that adversely affect the immune system;
• observe the rules of hygiene.

Forecast

If the treatment of ozena is not started in a timely manner, complications such as ozenous pharyngitis, hearing loss, chronic sinusitis, gastritis, tracheobronchitis, bronchopneumonia, and depressive states may occur.

Many parents are faced with the need to study such an issue as ozena - symptoms, treatment. Photos of this disease do not convey the complexity of the situation, which boils down to the fact that the child's nose turns into a source of unpleasant odor.

Moreover, various complications are possible, which have a significant negative impact on well-being.

The essence of the disease

Within the framework of the topic: “Ozena - symptoms, treatment, diagnosis”, it is worth initially defining this disease. Under such a diagnosis as ozena (fetid runny nose), it is worth understanding a process that has an atrophic character, which affects the mucous membranes, cartilage and bone tissues of the nose. In such a state, a viscous secretion occurs, which quickly dries up in the crust. Subsequently, it exudes an unpleasant odor.

Such processes in most cases are the result of exposure to the body of inflammatory and infectious diseases. At the same time, the unpleasant is effectively eliminated only after determining the root cause of the problem.

Reasons for the appearance

Many experts in the field of otolaryngology identify several key reasons for the appearance of a fetid

This group includes the following factors:

Damage to the trigeminal nerve and autonomic nerve trunks;

Injuries to the bones of the facial skeleton and nose;

The development of infectious diseases such as chicken pox, measles, rubella, diphtheria and scarlet fever;

Chronic infectious foci (sinusitis, rhinitis, pharyngitis, tonsillitis);

In some cases, poor nutrition can also be the cause of ozena.

Signs of illness

With a disease such as ozena, symptoms, treatment and diagnosis deserve special attention, since such atrophic processes cause a lot of discomfort to both the child and his parents.

And if you study the manifestations of ozena, then it will be possible to distinguish three key stages in the development of this disease: the initial stage, the peak stage and the final one.

In most cases, the initial stage develops at the age of 7 years and proceeds quite slowly, without the manifestation of noticeable symptoms. Only after some time, parents can pay attention to the fact that the child has discharge from the nasal cavity. Initially, they can be viscous, but after that they still take on a purulent form, becoming a source of an unpleasant odor.

With a problem such as ozena, symptoms, treatment and preventive measures imply a timely response to the manifestations of the disease. Obvious signs include headaches that are unusual for children, sleep disturbance, increased fatigue, weakness, and decreased appetite.

It is worth noting that it is quite difficult to eliminate the lake at the initial stage. Over time, the smell that the formed ones exude becomes noticeable to everyone around, but at the same time the child himself gradually loses sensitivity to it. This is due to the fact that the work of olfactory receptors is disturbed. Another cause of loss of sensitivity to smell can be hyposmia.

The peak stage is characterized by the expression of complete symptoms. A large number of crusts form in the nasal cavity, which are quite difficult to remove. Moreover, it becomes difficult for a child with ozena to breathe through the nose. In this case, a viscous liquid is constantly released. In addition to these manifestations, the symptoms of the heat stage include increased fatigue and lethargy, as well as pain in the forehead and nose, as well as a reduced degree of taste sensitivity. Parents should also take into account the fact that nosebleeds are possible during lakes, and frequent ones.

Continuing the topic: "Ozena - symptoms, treatment in children", it is worth noting that a doctor, when examining a child with a fetid rhinitis, often fixes characteristic signs of underdevelopment of the nasal pyramid, dilated nasal passages and nostrils, as well as unnatural thickening of the lips.

As for the final stage of the lake, it is irrelevant for an early age. This form of the disease is fixed in those who have already reached the age of 40. In this condition, the crusts in the nose and the smell also disappear, but the manifestations of atrophic chronic rhinitis remain.

Complications

Speaking of complications, it is worth mentioning ozeous pharyngitis, laryngitis, laryngotracheitis, chronic sinusitis, which includes frontal sinusitis, sphenoiditis and sinusitis. Complications that manifest themselves through inflammatory processes in the eyeball area are not excluded: keratitis, dacryocestitis, conjunctivitis, blepharitis. Ear inflammations are also possible, which include otitis and eustachitis of the ear.

When studying a disease such as ozena, symptoms, treatment and its possible complications, one should not forget about the long-term consequences of this disease: meningitis, pneumonia, bronchitis, trigeminal neuralgia and craniocephalic syndrome.

It is also important to know that as a result of swallowing pus secreted in the nasal cavity, the child may experience complications related to the gastrointestinal tract. We are talking about problems such as gastritis, constipation, flatulence and dyspepsia.

Atypical manifestations

In those patients who are congenital, unilateral ozena may occur. In this condition, there is a narrowing of one half of the nose and an expansion of the other. The algorithm for the development of a one-sided lake does not differ from the classical version.

Sometimes crusts appear in limited areas of the nasal cavity, without affecting it all. In this case, the formations are most often fixed in the middle nasal passages. Often this kind of ozena can lead to atrophy of the rear parts. In some cases, the ozena does not form a crust, but a viscous discharge is still present.

Diagnostics

One of the conditions for the successful treatment of a fetid rhinitis is a competent and timely response to the manifestations of such a disease as ozena. The symptoms of this disease are most pronounced at the height of the disease, so that parents can quickly identify the essence of the problem. But if at the initial stage there were assumptions regarding the development of ozena, then you need to contact an otolaryngologist and conduct endoscopic studies.

Rhinoscopy allows you to establish the degree of expansion of the nasal passages, choanae and shells. It is possible to identify the artrophic process, which is a consequence of ozena, using microscopy of the nasal mucosa.

Ozena: treatment

There are several techniques focused on the ineffective neutralization of a fetid rhinitis. The most common are surgical and medical methods.

Traditional methods include deodorization, removing the accumulation of crusts and In order to achieve a similar effect, washing with a three percent solution of hydrogen peroxide, saline and potassium permanganate is used.

It is possible to carry out tamponade according to Gonstein. We are talking about the use of a swab soaked in a solution of glycerin and placed in the nasal cavity. In this position, the tampon is left for 1-2 hours. Its subsequent extraction allows you to remove crusts from the nasal cavity, which are a source of an unpleasant odor.

Attention also deserves the treatment in which chlorophyllocarotene paste is used. It looks like this: a candle from this paste is placed in each sinus, as a result of which an unpleasant odor disappears after 10-15 minutes. This effect persists throughout the day.

As for surgical treatment, it may involve transplantation of autografts, implantation of acrylic sticks and the introduction of an implant under the mucous membrane of the septum and nasal wall.

Ozena: symptoms, antibiotic treatment

When the symptoms of ozena have been identified in a child, treatment is possible both in a hospital and on an outpatient basis. In this case, antibiotics are often used. The most effective among them is considered to be "Streptomycin". It can be administered intramuscularly and in the form of inhalation or ointments. In some cases, Metacycline is used.

With lakes, the use of chlorophyllocarotene paste can also be indicated.

The use of iron preparations, nicotinic acid, Prozerin, aloe juice, vitreous and Pyrogenal is popular.

As for physiotherapeutic methods, they include UHF on the region of the cervical sympathetic nodes or endozonal electrophoresis of potassium iodide.

Folk methods

With such a problem as ozena, home treatment should not be ignored. The use of folk methods can significantly help with a fetid runny nose. Here are a few recipes that make sense to pay attention to:

Grind the sea kale to a powder and inhale it in small amounts into the nose three times a day. This procedure will prevent the appearance of crusts.

Mix equal parts peppermint, wormwood and sage. Then place 5 tablespoons of the resulting herbal mixture in a liter of boiling water. You need to insist them for 2 hours in a thermos. You can rinse your mouth with this infusion, and also take it every day (3 glasses per day).

Every day, bury the nose with a few drops of milk thistle, rosehip and sea buckthorn oil, alternating them. The procedure should be repeated 4 times during the day.

It is obvious that the topic “ozana - symptoms, treatment” is relevant for many people, and with an integrated approach to the recovery process, there is every chance to overcome the negative consequences of this disease.

(fetid runny nose) - a progressive atrophic process that occurs in the mucous membrane, cartilage and bone structures of the nose and is accompanied by the release of a viscous secret with an unpleasant odor that dries into crusts. Clinically, ozena is manifested by a constant viscous discharge from the nose, a putrid odor of secretions, the presence of abundant crusts in the nose, loss of smell, and other symptoms. Of the diagnostic studies for lakes, rhinoscopy, pharyngoscopy, CT and radiography, bacteriological examination of nasal secretions are used. In the treatment of ozena, both medical (antibiotic therapy, washing and instillation of the nasal cavity, physiotherapy) and surgical (moving the side walls of the nose, implantation of allo-, homo- and autografts, implantation of ivalon, etc.) methods are used.

General information

Ozena has been known to medicine since ancient times. The description of the signs of this disease is found in the manuscripts of the Egyptians and Hindus, written in 1000 BC. e. Currently, ozena is quite rare and accounts for 1-3% of all diseases of the nose and paranasal sinuses. Mostly people under 40-50 years old get sick, most often - children. In women, ozena is observed more often than in men. Cases of ozena have never been noted among mulattoes, representatives of the Negroid race and Arabs.

According to clinical observations, modern otolaryngology identifies the following trigger factors leading to the development of ozena: trauma to the nose and bones of the facial skeleton, damage to the pterygopalatine ganglion, autonomic nerve trunks and trigeminal nerve, various infectious diseases (rubella, scarlet fever, measles, diphtheria, chickenpox ), chronic infectious foci (chronic rhinitis, adenoiditis, tonsillitis, sinusitis, pharyngitis), poor social conditions, bad habits, eating disorders.

Causes of ozena

Despite the fact that ozena is a very ancient disease, its exact etiology has not yet been named. To date, there are many theories that have emerged as a result of the constant attempts of scientists to find the causes of ozena.

The so-called anatomical theory suggests that ozena is associated with an increased width of the nasal passages from birth, an excessively wide facial skull and underdevelopment of the paranasal sinuses. The pathophysiological theory suggests that ozena is the result of past inflammatory processes in the nasal cavity. The infectious theory is based on the fact that a large number of diverse microflora are sown in patients with ozena. A single causative agent of ozena has not yet been identified, however, in about 80% of cases, Klebsiella ozena is determined in bakposev. According to the focal theory, ozena occurs as a result of changes in the paranasal sinuses, which is confirmed by the presence of sluggish chronic sinusitis in many patients with ozena.

Also known is the hereditary theory of ozena, based on the facts of family cases of the disease. She does not speak about the direct inheritance of ozena, but about a genetic predisposition to it, against which various trigger factors lead to the development of the disease. The neurogenic theory betrays paramount importance in the pathogenesis of ozena to a violation of autonomic innervation due to dysfunction of the parasympathetic and sympathetic nervous system. The endocrine theory of the occurrence of ozena was based on the features of the course of this disease in women, characterized by a change in the severity of symptoms during the period of hormonal changes (menstruation, pregnancy, menopause).

Ozena symptoms

In its course, the lake goes through 3 successive stages: initial, peak and final, each of which is characterized by its own characteristics.

The initial stage of ozena in most cases occurs at the age of 7-8 years. The disease begins imperceptibly and develops gradually. After some time from the beginning of the ozena, the child's parents pay attention to the fact that he almost constantly has discharge from the nose. The discharge initially has a viscous consistency, over time it acquires an unpleasant odor and becomes purulent. A sick child with ozena may occasionally experience headaches, increased fatigue, sleep disturbances, weakness, loss of appetite.

The initial stage of ozena is distinguished by a persistent progressive course, which is almost impossible to stop by any of the existing methods of treatment. As a result of the development of the disease, crusts begin to form in the nose, the smell of discharge from the nose becomes putrid and is well felt by people around. The unpleasant odor coming from the nose of a child with ozena intensifies even more during puberty. At the same time, the patient himself gradually ceases to feel this smell, which is associated with damage to the olfactory receptors of the nasal cavity and the occurrence of hypoosmia.

The stage of the height of the lake has a pronounced clinical picture. In this stage of ozena, patients note the presence of a large number of hard-to-remove crusts in the nose, difficulty in nasal breathing, constant discharge from the nose of a viscous consistency, nasal congestion and dryness, a complete lack of smell, a decrease in taste sensitivity, pain in the forehead and nasal pyramid, poor sleep, increased fatigue and lethargy. With lakes, nosebleeds are possible.

Examination of a patient with ozena, as a rule, reveals signs of underdevelopment of the facial skull and in particular the pyramid of the nose, thickened lips, wide nostrils and dilated nasal passages. There is a discrepancy between the wide nasal passages, typical for Ozena, and the patient's complaints about difficulty in nasal breathing, which is explained by a decrease in the sensitivity of tactile receptors, which normally perceive air circulation in the nasal cavity.

The final (terminal) stage of ozena usually occurs no earlier than 40 years of age. At this stage, the formation of crusts in the nose stops, the discharge and the associated unpleasant odor decrease and completely disappear. The final stage of ozena is considered a spontaneous cure of the disease. However, the atrophic changes in the structures of the nose that have occurred lead to persistent preservation of the symptoms of chronic atrophic rhinitis after an ozen: dryness in the nose and anosmia.

Atypical forms of ozena

Unilateral ozena occurs in patients with a significant curvature of the nasal septum, as a result of which there is an expansion of one half of the nose and a narrowing of the other. One-sided ozena has a course characteristic of the classic ozena, but develops only in the wider half of the nose.

Localized ozena captures only limited areas of the nasal cavity. Most often, the middle nasal passages are affected. Often, with a localized lake, atrophy is observed only in the posterior segments of the middle nasal passages, while hypertrophy is noted in their anterior sections.

Ozena without crusts is not accompanied by viscous secretions, the presence of crusts and an unpleasant odor. At the same time, all other signs of ozena take place, which can be manifested to varying degrees.

Ozena Complications

Local complications of ozena include: ozena laryngitis, ozena pharyngitis, laryngotracheitis, chronic sinusitis (frontal sinusitis, sinusitis, ethmoiditis, extremely rarely - sphenoiditis), inflammatory processes of the eyeball (conjunctivitis, blepharitis, dacryocystitis, keratitis) and ear (chronic otitis media, eustachitis ).

Long-term complications of ozena can be: bronchitis, pneumonia, trigeminal neuralgia, craniocephalic syndromes, meningitis. In connection with the long-term constant ingestion of pus released during the lake, complications from the gastrointestinal tract may occur: dyspepsia, gastritis, constipation, flatulence. Psychasthenic complications of ozena are possible: memory loss, depression, intellectual apathy, neurasthenia, etc.

Ozena diagnostics

In the initial stage, the diagnosis of ozena is very difficult, especially in children who are often treated for a long time by an otolaryngologist with a diagnosis of chronic rhinitis. At the peak stage, the characteristic clinical picture of the disease and the results of endoscopic studies leave no doubt that the patient has ozena. Rhinoscopy reveals dilated nasal passages; atrophy of the mucosa, turbinates and choanae; densely covering the mucous crust, having a yellowish-green or dirty gray color. When the crusts are removed, a pale, extremely thinned, but not bleeding, nasal mucosa is visible under them. A significant expansion of the nasal passages in patients with ozena leads to the fact that the posterior pharyngeal wall, the entrance to the sphenoid sinus, and the movements of the soft palate during conversation or swallowing are visible through them.

Microscopy of the nasal mucosa during lake reveals metaplasia of its cylindrical ciliated epithelium into keratinized squamous. The spread of the underlying atrophic process into the pharynx leads to the fact that during pharyngoscopy atrophic changes in the posterior pharyngeal wall are determined, as well as signs of atrophic laryngitis.

Radiography of the skull and paranasal sinuses in patients with ozena determines atrophic processes in the bone structures of the nose and in the walls of the sinuses: lacunar resorption and thinning of the bone beams with the replacement of bone tissue with fibrous tissue. The same changes are observed on CT of the skull and paranasal sinuses. To verify the pathogens in the nasal cavity, patients with ozena are prescribed a bacteriological study of secretions and swabs from the nose and throat.

Ozena treatment

The lack of accurate data on the etiology of ozena and the variety of theories of its occurrence have led to the emergence of various methods of its treatment. In clinical practice, both medical and surgical methods have found their application. Drug treatment of ozena includes general therapy and local medical procedures. The general therapy of ozena is reduced to rational antibiotic therapy with drugs to which, according to the antibiogram, Klebsiella ozena is sensitive.

Local treatment of ozena is carried out by regular washing of the nasal cavity with 0.9% solution of sodium chloride, disinfectant and alkaline solutions. In order to better remove the crusts present in the nose, before such washing, the nasal cavity is plugged with turunda with proteolytic enzymes. After removal of secretions and crusts from the nose, endonasal instillations and ointments are applied. To do this, use a weak solution of silver nitrate, fortified oils, Lugol's solution, sea buckthorn oil, oil solutions of vitamins E and A. In the local treatment of ozena, physiotherapeutic methods are also used: UV, laser therapy, electrophoresis of solutions of potassium iodide, chymotrypsin, nicotinic acid.

In the surgical treatment of ozena, there are several methods. Due to the fact that ozena occurs in wide nasal passages, methods have been developed aimed at reducing the width of the nasal passages. These include operations to move the side walls of the nose, implantation of an alloplast (usually Vaseline or paraffin) under the mucous membrane of the walls and septum of the nose, implantation of acrylic sticks or balls, transplantation of homo- and autografts.

In the treatment of ozena, methods of stimulating the trophism of the nasal mucosa have found their application. One of them is the implantation of ivalon in the region of the posterior part of the nasal septum, where the autonomic nerve plexus is located, on which it has a stimulating effect.

Ozena treatment methods are used, which contribute to additional moisturizing of the nasal mucosa. The Almeida method consists in creating a drainage hole in the lacrimal sac, through which the tear enters the middle nasal passage. The method of treatment of ozena according to Witmaak consists in suturing the duct of the parotid gland into the cavity of the maxillary sinus, from where its secret enters the middle nasal passage.

Ozena, or a fetid runny nose, is an atrophic process that progresses rapidly. The disease affects the nasal mucosa, cartilage and bone tissue. The characteristic symptoms of this pathology are a viscous secret released from the nose, and abundant dried crusts that exude an unpleasant odor. The causes of this disease are not yet fully determined, doctors only make assumptions. The symptoms and treatment of ozena are quite specific and require an integrated approach.

Causes

Around the fetid rhinitis, discussions have been going on for many years. It has not yet been possible to determine the exact cause of ozena, but there are a number of particularly interesting theories that doctors adhere to:

• Infection of the mucosa with a special bacteria called Klebsiella ozena. In almost 80% of patients, bacterial culture from the nose determines this pathogen. But pathology can begin against the background of infection with other bacteria.
• Disorders of the nervous system. This includes the pathology of the cervical sympathetic nodes and the palatine nodule.
• Endocrine disorders. This phenomenon is often observed in girls during puberty. Perhaps the development of ozena during pregnancy, as well as during menopause.

Ozena is most commonly diagnosed in adolescent girls and young girls. This problem is sometimes faced by people of senile age, who have constantly parched nasal mucosa.

Drying of the nasal mucosa and the appearance of a fetid odor can occur with a combination of certain factors:

• too wide nasal passages;
• recent diseases of the nasopharynx;
• a constant source of infection in the nasopharynx or oral cavity;
• genetic predisposition - when someone from close relatives suffered from ozena;
• persistently reduced immunity.

One or more of these factors can trigger the development of an ozena. The first symptoms of pathology can begin to appear even in childhood, and the disease progresses already in adolescence.

Poor nutrition, unfavorable living conditions, bad habits and improper treatment of infectious diseases can provoke a fetid runny nose. Harmful working conditions can also lead to pathology.

Ozena is most often diagnosed in young people in developing countries.

Clinical picture

Ozena is a fetid runny nose that occurs with a characteristic clinical picture. You can suspect this pathology based on the following signs:

• dryness of the nasal mucosa;
• many dense crusts in the nasal cavity;
• difficulty in nasal breathing;
• an unpleasant smell from the nose, which is noticed by others, but rarely felt by the sick person himself;
• impaired or completely absent sense of smell.

With lakes, there may be other symptoms - severe pain in the nose, periodic nosebleeds and viscous mucus.

Ozena can be unilateral, when only one nostril is affected, and bilateral, when the inflammatory process has covered both nasal passages. The unilateral form is most often observed with a curvature of the nasal septum. A fetid runny nose usually proceeds with the formation of crusts, although it happens that the crusts do not stick at all, and a viscous secret flows from the nose.

There are several degrees of severity of the fetid runny nose. With a mild degree of severity, the sense of smell is not at all disturbed, as is nasal breathing. With moderate severity, both nasal breathing and sense of smell are impaired. They are temporarily restored after careful cleansing of the nasal cavity from crusts. In severe cases, dry crusts can be not only in the nose, but also in the throat. In this case, nasal breathing and sense of smell are persistently impaired.

The first symptoms of ozena can already be seen in preschool girls. This is a constant viscous discharge and a fetid smell from the nose. Usually such children get tired quickly and constantly want to sleep.

Diagnostics

A fetid runny nose is diagnosed based on the patient's complaints. At the same time, it is important for the doctor to find out how long the patient has experienced such a phenomenon and when he began to notice a large number of crusts in his nose. In addition, the specialist must find out if any of the close relatives of the patient suffered from ozena. There is an assumption that this pathology can be inherited.

Be sure to find out the living conditions of the patient, as well as the presence of chronic diseases. Particular attention is paid to who the patient works for and whether his working conditions are harmful. In the history of the disease, injuries to the nose are recorded, as well as congenital structural features of the nasal septum.

In addition, to clarify the diagnosis, the doctor may prescribe the following types of examinations:

• Rhinoscopy. This is an examination of the nasal cavity, which is carried out using special mirrors. On examination, the doctor sees brownish-green crusts and thinned mucous, which has a pale color.
• Pharyngoscopy. This type of study is necessary to determine whether the inflammatory process has spread to neighboring organs.
• Bacterial culture from the nasal mucosa to determine the pathogen.

If the doctor sees that the mucosa is very thin and atrophied, then a biopsy may be prescribed.. To do this, take a piece of mucous for examination.

At the initial stage, the diagnosis of ozena can be very difficult, especially in young children. Most often they are treated for chronic rhinitis, but such treatment has almost no effect.

Features of treatment

Ozena treatment should be comprehensive. First, the doctor finds out if there is a hidden source of infection in the body, and if it is, then appropriate treatment is prescribed.

It is worth knowing that the treatment of ozena can be both conservative and surgical. The use of traditional methods of treatment is also allowed.

Conservative treatment

This treatment can be done at home. It is aimed at eliminating unpleasant symptoms and alleviating the patient's condition. Conservative therapy may include:

• washing the nasal cavity with saline or alkaline mineral water, from which gas was previously released;
• instillation into the nasal passages of a 25% solution of glucose in glycerin;
• the use of drugs based on Streptomycin. Most often they are prescribed locally;
• in severe cases, broad-spectrum antibiotics such as Lincomycin or Erythromycin may be prescribed;
• the patient is recommended physiotherapy - electrophoresis and UHF;
• hormonal and iron-containing drugs may be prescribed.

In addition, iodine-based preparations and various oils can be included in the conservative treatment regimen to soften the crusts and easily remove them.

If you remove the crusts in the nose without first softening them, then there is a high risk of damage to the mucosa.

Surgery

There are several types of surgery that are used to relieve or eliminate the symptoms of ozena. The most commonly used methods are:

• Various implants are inserted under the mucous membrane, which allow you to slightly narrow the nasal passages.
• Produce a slight displacement of the side walls of the nose to prevent sticking of crusts.
• Surgical removal of the parotid duct may be performed.
• Sewing in a special polymeric material to stimulate the nerve plexus.

The expediency of surgical intervention is determined by the attending physician, but surgery is resorted to only if conservative methods do not give an effect.

What else can help the patient

In the treatment of ozena, you can also use some folk methods, but they should first be agreed with the doctor:

• Several times a day, it is required to rinse the nasal cavity with a decoction of horsetail. Such a decoction softens and disinfects the mucous membrane.
• Tea is brewed from wormwood and mint. It is necessary to take a teaspoon of herbs in a glass of water.
• It is useful to put kelp powder into the nose. This must be done twice a day. If necessary, seaweed powder can be mixed with a little water.
• Once a day, fresh onion juice mixed with liquid honey should be instilled into the nose.

It is allowed to wash the nose with a decoction of chamomile or calendula. The effectiveness of such decoctions can be increased by adding a little baking soda to them.

If a patient with ozena is allergic to medicinal herbs, then it is better to do with a saline solution.

A fetid runny nose is most common in teenage girls and young women.. This disease greatly affects the quality of life of the patient, forcing him to avoid society. Treatment of this pathology should be complex. It is allowed to use not only medicines, but also folk methods.

Runny nose is familiar to absolutely everyone, regardless of age. Most often it is a companion of colds, the body's reaction to allergens, the introduction of pathogenic microorganisms.

However, in 1-2% of cases, it indicates serious changes in the functionality of the mucous membrane, causing its degeneration - ozen.

Patients develop a putrid odor when exhaling through the nose, which leads to a decrease in social activity. In addition, irreversible atrophic processes of the nasal cavity occur. It is impossible to get rid of the disease on your own, the patient needs long-term complex treatment.

What is ozena and why does it appear

Ozena (from Greek - fetid runny nose) is a progressive inflammation of the nasal mucosa, which is accompanied by gradual cell atrophy. In complicated cases, the process extends to the bone tissue of the turbinates, which leads to thinning of the bone.

The disease develops in 3 stages, each of which is characterized by a specific clinical picture.

At the initial stage, the symptoms are similar to the usual rhinitis:

• smell problems;
• secretion of viscous mucus;
• periodic formation of gray crusts with an unpleasant odor;
• respiratory failure;
• dryness of the mucosa.

The patient, due to a decrease in the sense of smell, may not notice an unpleasant odor, indicating the development of the disease. Those around him clearly feel it. Questions and comments about this can provoke the development of social, emotional problems.

In the acute stage, there is a rapid drying of the mucus, the formation of fetid crusts in the nose, which are difficult to remove. The nasal passages noticeably expand (sometimes so much that the posterior wall of the nasopharynx and the entrances to the Eustachian tubes become visible through them). Pathology affects not only the sense of smell, but also taste buds. An atrophic process begins, the picture of which is visible during rhinoscopy.

During the transition to the last stage of the lake, the secretion of mucus and the formation of fetid crusts cease. It is believed that there is a process of self-healing, but atrophy is irreversible - a person has problems for life.

According to medical statistics, the disease is diagnosed more often in women during puberty. However, it can occur in children and the elderly.

Causes

Ozena has been known for a long time - the first mention was recorded for 1 thousand years BC. Until now, medicine cannot give a reliable answer why the patient develops fetid rhinitis.

Possible causes of the development of the disease:

• infectious lesion of the nasal cavity (Klebsiella ozena, Corynebacterium, Proteus);
• damage to the autonomic nerve trunks, trigeminal nerve, cervical sympathetic nodes;
• disruptions in the endocrine system;
• chronic diseases of ENT organs (tonsillitis, pharyngitis, rhinitis);
• acute pathologies of infectious etiology (measles, rubella, diphtheria).

In addition, factors contributing to the development of ozena are identified - injuries to the nose and bones of the facial skeleton, genetic predisposition, features of the anatomical structure of the skull, nasopharynx, low immunity. Increase the risks of bad habits, poor nutrition, iron and vitamin D deficiency, unfavorable social and domestic environment.

Sometimes the disease occurs against the background of radiation therapy, uncontrolled long-term use of vasoconstrictor drugs.

It is likely that a combination of factors and causes - becomes the impetus for the development of lakes.

Possible Complications

An unpleasant smell from the nose, which accompanies a person everywhere, causes emotional instability (neurasthenia, depression, depression, absent-mindedness, decreased concentration, impaired mental activity).

Lack of treatment provokes the development of various pathologies:

• eye diseases (conjunctivitis, blepharitis, keratitis, dacryocystitis);
• chronic sinusitis, including sphenoiditis, sinusitis;
• ozenous pharyngitis, laryngitis, larengotracheitis;
• hearing loss;
• inflammatory processes of the ears (eustachitis, otitis media).

The danger of the lake is difficult to overestimate. Severe cases can lead to disastrous consequences that threaten not only health, but also life (meningitis, pneumonia, bronchitis).

Prolonged ingestion of purulent mucus causes problems with the gastrointestinal tract (gastritis, constipation, flatulence).

In a neglected state, an irreversible deformation of the nose occurs.

How to treat

If a person has the first symptoms of ozena, treatment should begin immediately.

The disease is able to resolve on its own many years after its onset. This does not mean that it does not need to be treated. Properly developed therapeutic regimens, compliance with all the prescriptions and instructions of the doctor by the patient help to avoid serious consequences.

Considering that it is impossible to restore atrophied tissues, the treatment of ozena is symptomatic. It can be conservative or surgical, depending on the stage of the disease.

Main therapeutic goals:

• elimination of an unpleasant smell (deodorization);
• softening and removal of crusts from the nasal passages;
• impact on the pathogen;
• restoration of normal mucosal microflora.

In most cases, treatment is performed at home, with a significant lesion, hospitalization of patients with ozena is indicated.

Features of treatment. Antibiotic therapy

The basis of conservative therapy for Klebsiella infections is the appointment of antibacterial drugs that are active against pathogenic microorganisms. In most cases, they are administered intravenously.

The most effective antibiotics are Streptomycin, Levofloxacin. Based on the results of bacteriological culture, Oxacillin, Tseporin, Gentamicin, Metacycline, Erythromycin can also be prescribed.

In order to locally destroy the pathological microflora and moisten the mucous membrane, the nasal cavity is washed with disinfectant solutions (alkali, potassium permanganate, hydrogen peroxide, saline).

If necessary, iron, zinc, folic acid preparations are prescribed. With restless conditions, insomnia - light sedatives. To support the body's defenses - immunomodulatory drugs.

Sometimes autohemotherapy is performed - intramuscular injection of one's own blood, which allows you to strengthen the immune system, restore the functions of the endocrine system, and remove toxins from the body.

Goldstein's tamponade is effective in the treatment of ozena - a swab dipped in a mixture of iodine and glycerin is inserted into the nasal cavity for several hours. The procedure facilitates the process of removing crusts, contributes to the short-term relief of an unpleasant odor.

For the purpose of deodorization, drops based on menthol with boric acid, paste or candles with chlorophyllocarotene are used.

The treatment of ozena also has a psychological side. Patients are forced to be isolated from society because of the unpleasant smell emanating from them. Support of relatives and friends, work with a psychologist is an important component of rehabilitation.

Physiotherapy methods contribute to the speedy regeneration of tissues, reduce the manifestation of unpleasant symptoms (electrophoresis, iontophoresis, laser therapy, ultraviolet insolation).

Surgery

During surgical treatment, the nasal passages are narrowed. The operation is carried out only in agreement with the patient. To achieve the goal, scientists have developed several methods:

• displacement of the side walls of the nose;
• implantation of acrylic sticks;
• implantation under the mucous membrane of the walls and septum of the nose of the alloplast (most often paraffin, petroleum jelly are used);
• transplantation of autografts.

Two operations are considered to be the most effective - first implantation (implantation, transplantation), then after a couple of years - displacement of the side walls of the nose.

It is almost impossible to completely get rid of a fetid runny nose, even surgically. It is important to prevent the development of the disease. Preventive measures will help with this.

Prevention

In order not to encounter ozena, it is necessary to adhere to certain simple rules that increase the body's resistance:

• active lifestyle;
• hardening;
• daily walks in the fresh air;
• rejection of bad habits;
• timely treatment of all diseases;
• personal hygiene;
• avoidance of stressful situations;
• a complete balanced diet;
• adequate therapy of pathologies of ENT organs.

It is recommended to master the correct technique for clearing the nose of mucus, not to use vasoconstrictor drugs for a long time. Self-medication should be based on rinsing the nose with saline. If there is no improvement on the 5th day, be sure to consult a doctor.

In addition, it is necessary to maintain the optimum temperature in the room (19–22 ° C), monitor the level of air humidity (50–70%), constantly ventilate, and carry out wet cleaning daily.

Ozena (fetid runny nose) is a very unpleasant disease that significantly worsens the quality of life, and is practically untreatable. Atrophic processes are irreversible, it is only possible to temporarily stop the symptoms. If you find the first signs (unpleasant smell from the nose, the appearance of crusts), you need to seek medical help. Compliance with preventive measures will help prevent the development of pathology.