Ozaena is a disease that affects the lining of the nose. The term disease is derived from the Greek words for ‘stink’ and ‘bad smelling nasal polyp’. The disease is sometimes also called ‘rhinitis atrophicans cum foetore’. In colloquial language, the ozaena is also known as the stinky nose. The ozaena is relatively rare.
What is an ozaena?
In ozaena, the nasal mucosa is affected by pathological changes. The disease occurs with a very low prevalence in the general population. Medical science primarily distinguishes between two different forms of ozaena. These are the primary and secondary ozaena. See gradinmath for What are Corns.
According to current assumptions, the affected persons contract primary ozaena through genetic causes. In this form of the disease of the nasal mucosa, there is no association with other diseases. The secondary form of ozaena develops mainly in connection with other diseases or various external factors, for example as a result of a surgical intervention.
Typical of both forms of ozaena is the loss of tissue in the area of the mucous membrane of the nose. This phenomenon is known in medical terms as atrophy. As a result of this loss of mucosal tissue, a basis for life for bacterial pathogens is formed. These settle increasingly in the nose and lead to a strong, unpleasant smell. For this reason, the ozaena is colloquially named stink nose.
The exact reasons for the formation of the ozaena are still largely unexplored. This uncertainty as to the causes relates in particular to the primary form of the ozaena. In this case, however, doctors assume that a hereditary component is involved in the development of the disease. This type of ozaena primarily affects female patients from the pubertal phase onwards.
In addition, observations show that the disease tends to run in certain families. In the case of the secondary form of ozaena, the causes of the development of the disease have been better researched. External factors are primarily responsible for this, which lead to a decline in the nasal mucosa. Enlarged sinuses in the nose can also be a possible cause.
Other external influences of the secondary ozaena include damage to the sinuses or the nose, tumors in the nose and surgical interventions in the nasal area. Other risk factors are the intensive use of nasal sprays with a swelling-reducing effect and anomalies in the anatomy of the nasal septum.
Symptoms, Ailments & Signs
Various symptoms and complaints characterize the clinical picture of the ozaena. The cardinal symptom of the disease is a strong, foul-smelling odor emanating from the diseased nose. The odor forms as a result of the loss of mucosal tissue inside the nose.
This is because special types of bacteria are able to spread in the nose. These bacterial pathogens create a slimy coating in the nose. The coating exudes the characteristic odor of the ozaena, which smells foul. Not only the mucous membranes, but also the mucous glands are affected by the reduction of the mucous membrane in the nose.
This leads to progressive drying out of the inside of the nose. In addition, a typical bark develops, which is usually yellowish to black in color. The bark may have a negative effect on breathing through the nose. If the bark inside the nose detaches, there is often increased bleeding.
In addition, the olfactory nerves are also affected by the decline in tissue. As a result, the sense of smell of the sick patients deteriorates in many cases. In addition, the sense of taste is sometimes reduced. Due to the deteriorated sense of smell, the affected persons are not able to realize the foul-smelling stench from their nose.
Other potential complaints of ozaena are pain in the nose and head and pus formation. In the case of particularly severe disease progression, the bony part of the nasal concha regresses.
Diagnosis & course of disease
Ozaena is usually diagnosed by an ear, nose and throat specialist. The patient first explains his main complaints and the circumstances of their origin. Then the treating specialist examines the affected patient physically. For example, the doctor analyzes the condition of the mucous membrane of the nose through a rhinoscope.
Among other things, the typical bark and other abnormalities appear. In addition, the doctor usually makes a swab of the mucous membrane of the nose. As a result, the bacterial pathogens present can be precisely identified, so that targeted therapy is possible. An important criterion for the diagnosis of ozaena is the characteristic smell, which the doctor usually uses to quickly recognize the disease.
With this disease, those affected suffer from a very foul and unpleasant smell, which usually emanates from the nose. This odor cannot be removed even with the help of frequent washing and blowing of the nose. In many cases, this leads to inferiority complexes or a significantly reduced self-esteem in the patient.
Those affected are very often ashamed of the complaint and social difficulties arise. In children, ozaena can cause discomfort that leads to bullying or teasing. If the disease is not treated, the olfactory nerves in the nose are irreversibly destroyed so that they cannot be restored even after treatment.
Pain in the nose or in the head also occurs as a result of the illness and significantly reduces the patient’s quality of life. Unfortunately, the disease cannot be completely cured. However, the symptoms themselves can be alleviated with the help of sprays. Special complications usually do not arise. The life expectancy of the patient is also not negatively affected by the disease.
When should you go to the doctor?
The ozaena does not cause any major complaints at first. A doctor should be consulted if the nose is unusually dry or the typical odor is noticed. The yellowish-green or black discolouration should also be clarified quickly. The ENT doctor can diagnose the disease based on the characteristic discharges and take further measures.
Removing the crusts and pus can relieve symptoms. The doctor must surgically treat the causative malformation of the bony structure of the nose. If the symptoms mentioned appear during female puberty, it may be ozaena.
Injuries to the nose, tumors in the nasal cavity and malformations can also trigger atrophic rhinitis cum foetore. Anyone who has had an unusual odor from their nose after nasal surgery or excessive use of nasal sprays should inform their doctor. A specialist in ear, nose and throat medicine or a specialist in bone diseases is responsible.
Since the usually prescribed vitamin and zinc preparations can cause various side effects, you should consult your doctor closely. If the drugs prescribed are ineffective or the symptoms recur, surgical intervention may be necessary. For this, a specialist center for ENT must be visited.
Treatment & Therapy
The primary ozaena is often not completely curable. However, patients can use measures to relieve and improve symptoms that are also used in secondary ozaena. The constant moistening of the mucous membrane of the nose is particularly important. To this end, people drink plenty of water, use oily nose drops and special nasal douches.
Outlook & Forecast
The prognosis of the stinky nose often varies. In most cases, it cannot be completely cured. However, there are some ways to significantly reduce the symptoms and the unpleasant odor in the nose.
Because the ozaena is primarily caused by a dried-out nasal mucosa and its protective function is therefore lost, it is important to keep the nose moist. If the nasal mucosa can be consistently moistened, the prognosis of the stinky nose is usually more favorable. The patient must avoid dry rooms, especially in the winter months. In addition, the room climate can be improved by water scales on the heaters. Sufficient fluid intake also has a positive effect. This means that the affected person drinks at least two liters of water or other unsweetened beverages in order to have a beneficial effect on the course of the condition.
With the help of special nasal ointments, which are available in pharmacies, the milieu of the nasal mucosa can also be kept moist. Inhalation solutions with sodium chloride also serve as support. Regular professional nose cleanings by an ear, nose and throat doctor are also positive for the prognosis. Furthermore, bark in the nasal cavity should be regularly softened and removed.
If the patient consistently follows these measures, the symptoms of the ozaena can be well controlled so that their progression is effectively stopped.
Prevention of primary ozaena is difficult, while avoidance of risk factors can partially prevent secondary ozaena.
In the case of ozaena, there are usually only a few direct aftercare measures available to those affected. With this disease, a very early diagnosis is first and foremost necessary so that there are no further complications or symptoms. Since ozaena cannot heal completely, the focus of aftercare is more on relieving the accompanying symptoms.
This usually involves taking medication. The precise instructions of the doctor should be followed. Sometimes it can be helpful to get professional, mental support, as the disease is often accompanied by many feelings of shame. The feeling of smelling unpleasant can lead to reduced self-confidence in those affected. In order to permanently reduce the odor, special hygiene measures should be observed.
You can do that yourself
An ozaena, which is popularly known as a “stink nose”, is extremely difficult to treat. Complete healing is often not possible, especially in the case of a primary ozaena, i.e. if it is genetic. The main focus of treatment is to reduce the predominant symptoms. Most of those affected are above all repelled by the unpleasant smell, which is why they look for ways in everyday life to get rid of it accordingly.
Most importantly, patients try to keep the nasal mucosa moist. A regular and sufficient supply of liquid as well as intensive care of the nose are crucial. It is particularly bad for those affected in the colder months of the year, as dry heating air or air conditioning systems make the situation even worse. Patients should therefore avoid dry room air and consciously humidify the air. This can be achieved with special measures, such as hanging up damp cloths in the room, placing bowls of water on the radiator, ventilating regularly or attaching humidifiers to the radiator.
In addition, those affected should drink at least two to three liters of water a day. Regular nasal douches with salt water also help to restore the quality of life despite ozaena. As a result, the nasal mucosa is sufficiently moistened and the incrustations can be removed more easily. Taking zinc or vitamin A and vitamin E can also change the clinical picture for the better.