Smelly nose

Synonyms in a broader sense

Medical: Ozaena; Rhinitis atrophicans cum foetore

English: ozena

definition

The smelly nose (ozaena) is characterized by degeneration of the nasal mucous membrane with a loss of smell (anosmia). In the nose there is tough, smelly mucus and numerous crusts and crusts.

causes

In the healthy, the Nasal mucosa many important functions. It warms and moisturizes the air inhaled through the nose. Inhaled dust particles adhere to the moist mucous membrane and are transported away via the nasopharynx along with the nasal secretions and are usually swallowed. Bacteria and viruses, which permanently penetrate the body via the air flow, also encounter a first defense barrier on the nasal mucous membrane. The moist 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.

So that the sensitive mucous membrane does not dry out, it swells alternately over 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 restricted. There are diseases in which the mucous membrane loses its ability to keep moisture and clean itself. This results in a creeping decline of the tissue, called atrophy in medical terminology. It comes to Expansion of the nasal cavity, which now has more space after the nasal mucous membrane has shrunk. As a result of the increased space available, turbulences in the air flow occur, which further dry out the nose, which enables harmful bacteria to spread on the attacked mucous membrane and decompose it.
This can result in an unpleasant smell that is also perceptible to the environment, a smelly nose. One distinguishes one in medicine primary and a secondary smelly nose (Ozana). In the case of the primary smelly nose, no trigger for the regression of the nasal mucosa can be identified. This regresses due to as yet unexplained causes together with the supplying vessels and sometimes even surrounding bony structures. A trigger can usually be seen in the secondary form. Usually this is to be found in medical interventions or applications. Which operations favor the appearance of a smelly nose is dealt with in the following paragraphs.

The smelly nose occurs more frequently in women and is often inherited. Operations and injuries to the nose can lead to later destruction of the nasal mucous membrane.
Years of abuse of decongestant nasal drops and sprays (Privinism) can cause a smelly nose.

Please also read our page Dependence on nasal spray

When patients with a tumor in the face area X-rays have been treated, the nasal mucosa may later degenerate with subsequent development of a smelly nose.

Smelly nose after an operation

Surgery that liberally removes tissue within the nasal cavity can leave a large cavity. This is possible, for example, during tumor operations or when removing entire turbinates in the case of obstructed nasal breathing. Turbulence in the air flow can promote drying out and bacterial colonization of the nasal mucous membrane after the operation. It is also conceivable that the mucous membrane may decrease after damage to blood vessels.

Nasal polyps are benign growths of the nasal mucous membrane that often occur in chronic inflammatory conditions and swollen mucous membranes. If the polyps occur more frequently, nasal breathing can be severely restricted, which reduces the general feeling of those affected. If nasal polyps obstruct the outflow of nasal secretions, this can lead to secretion retention and recurring inflammation of the paranasal sinuses.

If the disease can no longer be adequately treated with medication, such as the use of decongestant nasal drops, surgery may be necessary. As with tumor surgery, the removal of nasal polyps creates a wound surface on the nasal mucous membrane or on the mucous membrane of the paranasal sinuses. If this is not adequately supplied after the operation, a smelly nose can develop through bacterial colonization and decomposition processes. In the past, when nasal breathing was impeded, a turbinate and the mucous membrane that grew over it were often removed in order to create more space for the air flow. As a result of this, the remaining mucous membrane occasionally dried out and a smelly nose developed, this method is being abandoned more and more today.

The development of a smelly nose after dental surgery is extremely rare. This is conceivable for an operation on the upper jaw if the operating area extends into the sinus of the upper jaw (Maxillary sinus) extends. This can be the case with extensive tooth removals or with ulcerated tooth roots.

Smelly nose from nasal spray

The occurrence of a smelly nose has also been described with intensive use of decongestant nasal sprays. These sprays contain an active ingredient that causes the blood vessels that supply the nasal lining to contract. This leads to a swelling of the same and the user has the feeling of being able to breathe better through the nose. Permanent use However, these sprays can also be used for Regression of the mucous membrane lead, which thereby loses its protective function and is colonized by bacteria in individual cases. Nasal sprays should therefore never be used over a long period of time.
Especially people who attend Allergies sufferers tend to use nasal sprays daily for months and sometimes years to avoid being allergic swollen mucous membrane to ease restricted nasal breathing. Since the mucous membrane swells immediately after stopping the spray in order to counteract its drying out, the affected person becomes really dependent on the substance. You should therefore ask your doctor or pharmacist how the supply of the spray can be reduced permanently. Table salt spraysthat do not contain an active ingredient can be an alternative.

Please also read our page Dependence on nasal spray.

Symptoms

In the case of the smelly nose, through bacterial colonization of the nasal mucosa and their decomposition creates an unpleasant odor, which is usually imperceptible to those affected. Therefore, relatives and other close contact persons often first become aware of the disease.
With a sharp decrease in the mucous membrane and the resulting sharp enlargement of the nasal cavity, the sick have the paradoxical feeling that nasal breathing is impeded. This is explained by the conversion of the linear air flow, which prevails when the nasal cavity is intact, into a swirling air flow, which occurs when it becomes enlarged due to the disease. With the smelly nose, due to the damaged nasal mucous membrane, there can also be frequent Epistaxis and purulent nasal discharge occur. The symptom complex is occasionally accompanied by crusty and barky ones Toppings.

Patients with a smelly nose suffer a great deal. The nose itself doesn't really cause them any more problems than one sniff. However, those around you can hardly bear the carrion-like stench that your nose produces through the decomposition of the nasal mucous membrane, but cannot smell it (anosmia). Such patients can experience significant social and professional problems.

therapy

It is particularly important to keep the mucous membrane of the stinky nose moist and supple, as every formation of crusts and barks leads to the decomposition of tissues and thus to the formation of carrion-like smells.
Oily nose drops (Coldastop®) or bromhexine (Lubrirhin®) and the inhalation of salt water (Emser Sole®) and regular moisturizing Seawater nasal sprays can help.
With nasal ointments (Bepanthen® nasal ointment) an approximate attempt at healing can be aimed for. An ingestion of vitamins A and E is said to have a progressive destruction of the Nasal mucosa prevent. In none In this case, decongestant nasal drops with xylometazoline or oxymetazoline should be used again, because they would only promote the disease.

The doctor (in the rain ENT - doctor) will help the patient in severe cases to remove the crusts and crusts.
In some cases, a surgery Bring relief. Parts of the cartilage are transplanted or an artificial passage to the oral cavity is created, which is supposed to induce saliva to moisten the nose.

forecast

A smelly nose is in most cases unfortunately not completely curable. Nevertheless, the symptoms and thus also the unpleasant smell can be prevented by taking some measures effectively reduced become.
As has already emerged from the previous sections, the appearance of a smelly nose is largely due to the drying out of the nasal mucous membrane and its lost protective function. The aim of symptomatic therapy must therefore be to To keep your nose moist. Especially in the winter months avoid dry room air become. Water bowls on the radiators can help through evaporation and improve the room climate. Those affected should also ensure they are drinking enough fluids. At least two liters of water or unsweetened drinks are recommended for a healthy adult.

There are several in the pharmacy Nasal ointments available that keep the mucosal environment moist. Inhalation solutions containing saline support the self-cleaning function of the nose. The ENT doctor should have a professional at regular intervals Nasal cleaning can be carried out to loosen deposits and incrustations. All of these measures help, provided they are used in a disciplined manner, to reduce the symptoms of a smelly nose. The disease can be effectively prevented from progressing, but not completely cured.