Synonyms in a broader sense
Medical: Ozaena; Rhinitis atrophicans cum foetore
Definition
The stinky nose (ozaena) is characterized by a degeneration of the nasal mucosa with loss of the olfactory ability (anosmia). The nose contains tough, stinky mucus and numerous incrustations and bark.
Causes
In healthy people, the nasal mucous membrane fulfils many important functions. It warms the air inhaled through the nose and moistens it. Inhaled dust particles adhere to the moist mucous membrane and are transported away together with the nasal secretion via the nasopharynx and usually swallowed.
Bacteria and viruses, which permanently penetrate the body via the air stream, also encounter an initial defence barrier at the nasal mucosa. The humid environment prevents them from penetrating deeper into the respiratory organs. Immune cells of the body, which are located in large numbers in the mucous membranes, can render the pathogens harmless.
To prevent the sensitive mucous membranes from drying out, they swell strongly in the course of the day, so that the moist surface can regenerate. In some cases, however, the protective function of the nasal mucosa can be severely limited. There are diseases in which the mucous membrane loses its ability to keep it moist and self-cleaning.
This results in a gradual decline of the tissue, known in medical terminology as atrophy. The nasal cavity expands, which now, after the shrinking of the nasal mucosa, has more room. As a result of the increased space, turbulence of the airflow occurs, which further dries out the nose, allowing harmful bacteria to spread and decompose on the affected mucous membrane.
This can result in an unpleasant smell, also perceptible to the environment, a stinky nose. In medicine, a distinction is made between a primary and a secondary stinky nose (ocaena). In the case of the primary stinky nose, no trigger for the regression of the nasal mucosa can be identified.
For reasons as yet unexplained, the nasal mucosa is regressing, together with the vessels supplying it and, in some cases, even surrounding bony structures. In the secondary form, a trigger can usually be identified. In most cases, this trigger is found during medical interventions or applications.
The following paragraphs describe which operations promote the appearance of a stinky nose. The stinky nose occurs more frequently in women and is often congenital. Operations and injuries to the nose can promote subsequent destruction of the nasal mucous membrane.
Also, years of abuse of decongestant nasal drops and sprays (privinism) can cause a stinky nose. If patients have been treated with X-rays because of a tumor in the area of the face, a degeneration of the nasal mucous membrane with subsequent development of a stinky nose can occur later. Surgery that generously removes tissue within the nasal cavity can leave a large cavity behind.
This is possible, for example, during tumor operations or the removal of entire nasal conchae in cases of impaired nasal breathing. Turbulence of the airflow can promote drying and bacterial colonization of the nasal mucosa after surgery. Also the regression of the mucous membrane after damage to blood vessels is conceivable.
Nasal polyps are benign growths of the nasal mucosa, which occur more frequently in chronic inflammatory conditions and swollen mucosa. If the polyps are more frequent, nasal breathing can be severely restricted, which reduces the general feeling of the affected person. If nasal polyps obstruct the outflow of nasal secretion, secretion retention can occur, resulting in recurrent inflammation of the paranasal sinuses.
If the disease can no longer be adequately treated with medication, such as decongestant nasal drops, an operation must occasionally be performed. As with tumor surgery, after the removal of nasal polyps, a wound surface develops on the nasal mucosa or on the mucosa of the paranasal sinuses. If this is not adequately treated after the operation, a stinky nose can develop due to bacterial colonization and decomposition processes.
In the past, if breathing was impaired, a nasal concha and the mucous membrane overgrowing it was often removed to create more space for the airflow.As a result, the remaining mucosa occasionally dried out and a stinky nose developed. The development of a stinky nose after dental surgery is extremely rare. This is conceivable in an operation on the upper jaw, if the surgical area extends into the maxillary sinus.
This can be the case with generous tooth extractions or with suppurated tooth roots. The occurrence of a stinky nose has also been described with intensive use of decongestant nasal sprays. These sprays contain an active ingredient that causes the blood vessels supplying the nasal mucosa to contract.
This leads to a decongestant effect and the user has the feeling of being able to breathe better through the nose. Long-term use of these sprays can, however, also lead to the regression of the mucous membrane, which then loses its protective function and in individual cases becomes bacterially colonized. Nasal sprays should therefore never be used over a long period of time.
Especially people suffering from allergies tend to use nasal sprays daily for months and sometimes years to ease nasal breathing restricted by allergic swollen mucous membranes. Since the mucous membrane swells up immediately after the spray is discontinued in order to counteract its dehydration, those affected become downright dependent on the substance. You should therefore ask your doctor or pharmacist how the intake of the spray can be permanently reduced. Salt sprays that do not contain an active substance can be an alternative.
