PRIMARY ATROPHIC RHINITIS IN A CHILD: A CASE REPORT AND LITERATURE REVIEW

Background: Atrophic rhinitis (AR) is a rare form of chronic rhinitis of unknown etiology, characterized by progressive atrophy and sclerosis of the nasal mucosa and underlying bone, leading to the formation of thick, dry crusts within abnormally widened nasal cavities. Case presentation: We report the case of a 13-year-old child, born from a non-consanguineous marriage and without any relevant medical history, presenting with recurrent purulent rhinorrhea, repeated epistaxis, nasal obstruction, and a foul-smelling odor. Nasal endoscopy revealed dilated, dry nasal cavities with crusts on the septum and lateral walls. Computed tomography (CT) of the paranasal sinuses showed chronic pansinusitis and diffuse atrophy of the nasal and sinus mucosa. Laboratory investigations were normal. Bacteriological analysis of the rhinorrhea was sterile. The patient was treated with isotonic saline irrigations, resulting in marked clinical improvement. Discussion: Primary atrophic rhinitis (PAR) is a rare but disabling chronic nasal disease. It results from progressive atrophy of the nasal mucosa, glands, vasculature, and even turbinate bones, leading to a wide, crusted nasal cavity and cacosmia. Several etiopathogenic hypotheses have been proposed, including infectious, nutritional, mechanical, and genetic factors. Diagnosis is mainly clinical, supported by imaging. Management remains largely symptomatic: nasal irrigation, topical vitamin A, corticosteroid sprays, or antibiotics.