Treatment of Atrophic Rhinosinusitis with Widening of the Nasal Cavity

Primary atrophic rhinitis (AR) with spontaneous onset presents with a characteristic clinical triad — widening of the nasal cavity, greenish nasal crusts, and foul nasal odor (foeter) — and progresses slowly over time. Recognising this triad informs the appropriate management strategy.

Clinical scenario

Primary AR arises spontaneously and is defined by the triad of widened nasal cavity, greenish crusts, and foeter. This progressive presentation requires a regimen that addresses both local crusting and nasal hydration, with consideration of individual clinical features.

Treatment approach

The cornerstone is conservative medical management, encompassing both local and systemic strategies. The regimen includes nasal irrigation and selected topical or systemic agents, with further options available depending on specific clinical findings. The complete protocol — including agent selection, sequencing, and individual criteria — is available via the link below.

Treatment goals

Decrease in nasal crust formation and increase in nasal hydration.

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References

DOI: 10.1177/01455613231185022

Primary AR is characterized by a triad comprising widening of the nasal cavity, greenish crusts, and foul nasal odor (foeter).
Primary AR presents with spontaneous onset and progresses slowly with time.
The mainstay of the management of AR is conservative medical management, locally or systemically.
The primary goal of AR management is to decrease crust formation, increase nasal hydration, and attempt to solve atrophy by managing the underlying causes.

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