الفهرس 
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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.