الفهرس | Only 14 pages are availabe for public view |
Abstract Frimary atrophio rhinitis is not unoommon in Egypt it is a ohronio inflammation of the nasal muoosa oharaoterised by roomy nasal fossae, visoid seoretion whioh rapidly dries and forms orusts whioh emit a oharaoteristio foul odour. The exaot aetiology of the disease is not yet well established, some attributed it to hereditary, poor nutrition or endoorinal faotors, and others due to ohronio infeotion in maxillary sinus in ohildhood. It appears about puberty and more oommon in females. In this study 30 patients with primary atrophio rhinitis were examined. Patients with atrophio stage of rhinoscleroma were exo luded. Examination of the sinus was done by sinosoope through oanine fossa. For eaoh patient histopathological and baoteriologioal examinations were done for both nose and maxillary sinus, on each side, to evaluate the condition of maxillary sinus in oase of primary atrophic rhinitis. Sinosoopioally we saw no ohange of maxillary sinus appearance in early oases of primary atrophio rhinitis while when nasal manifestations were advanced, atrophic ohanges of maxillary sinus lining mucosa became visible specially around its ostium with impairing its oiliary fu~t~n. We oould olassify histopathologioal ohanges in nose into three grades according to duration of affeotion. In the first grade, the nasal muoosa is oontaining more inflammatory calls with diminution of number of muous secreting glands, while maxillary sinus mucosa appears normal. In the second grade the nasal mucosa shows patohY squmous metaplasia, on the oontrary the sinus muoosa shows oompensatory hyperplasia of glands. Lastly in the third grade when the disease is advanced both nasal and maxillary sinus mUOosa show the same atrophic ohanges whioh were stratified squmous metaplasia with keratinization and loss of oilia, also there were loss of goblet oells and mucous glands with atrophy of lamina propria. Baoteriologically we found no relationship between atrophio ohanges in nose or sinus and the type of organism isolated from eaoh. Henoe histopathologioal examination of tissue is reoommended for every case diagnosed as atrophio rhinitis to oonfirm the diagnosis and determine the condition of the maxillary sinus. X-ray of the maxillary sinuses showed that 80% of the oases were opaque radiologically while the remaining 20% were olear. The dimentions of the maxillary sinuses were found to be reduced in about 53% of the cases. In those cases the lateral wall of the nose as well as the other walls of the sinus were thiokened. The outlines of the sinuses were olearly demarcated. By sinosoopical examination there was no suppuration in almost all the 08ses.So, X-ray pioture of paranasal sinuses as a diagnosis for ohronio sinusitis in a patient with primar,y atrophio rhinitis is of DO aotual value as there is already opaoity due to thiokness of the walls of the sinuses. |