STUDIES ON GENERAL FACTORS IN ATROPHIC RHINITIS, WITH SPECIAL REFERENCE TO THE FUNCTION OF EPIDERMAL ORGANS AND MESENCHYMAL TISSUE

Abstract

Fifty-two patients with atrophic rhinitis were divided into 3 groups, Iab, Ic and II, according to Kitamura's classification. The functional activities of some of the epidermal organs and mesenchymal tissue, as well as of the autonomic norve, were investigated, and the factors affecting the course of atrophic degeneration of nasal construction were examined from constitutional point of view. Patients with chronic sinusitis, who served as controls, were also examined.
As for the function of epidermal organs, the amount of secretion from the salivary glands and sweat glands was less in atrophic rhinitis than in chronic sinusitis. There was no difference in excitability of the vagus nerve between the two diseases. Atrophic rhinitis showed a higher incidence of abnormal sialographic findings in the parotid gland than chronic sinusitis. This observation may indicate some organic changes in the glands. As for the function of mesenchymal tissue, instability of the vasomotor nerve and fragility of the capillaries, as well as delayed reaction of the skin to Cantharidin, were specific in atrophic rhinitis. Review of consititutionl history revealed that patients with atrophic rhinitis were more predisposed to mucosal infections, with a higher incidence of other otorhinolaryngeal diseases. It seemed that they were slow in reacting to inflammatin and that inflammatory changes tend to become chronic.
Nasal sinuses were more poorly developed in patients with type Iab atrophic rhinitis than that in those with chronic sinusitis, indicating that congenital local factors might be concerned in the course of atrophic rhinitis of this type. Nasal mucosa of type II had atrophied after long severe rhinosinusitis, in spite of congenital local hyperplastic constitution of nasal mucosa, which had appeared in good developed paranasal sinuses. This seems to indicate that general factors are concerned in the development of atrophic rhinitis of this type. It was considered most likely that, in the development of type Ic atrophic rhinitis local unknown factors other than those that were found in the other two types were concerned, and that the same general factors as were found in the other two types were concerned in its development.