Atrophic rhinitis is a chronic nasal condition with unknown cause. It is characterised by the formation of thick dry crusts in a roomy nasal cavity, which has resulted from progressive wasting away or decrease in size (atrophy) of the mucous nasal lining (mucosa) and underlying bone. The various symptoms include foetor (strong offensive smell), crusting/nasal obstruction, nosebleeds, anosmia (loss of smell) or cacosmia (hallucination of disagreeable odour), secondary infection, maggot infestation, nasal deformity, pharyngitis, otitis media and even, rarely, extension into the brain and its membranes. Atrophic rhinitis can be classed as primary or, where it is a consequence of another condition or event, secondary. Its prevalence varies in different regions of the world but it is common in tropical countries. A wide variety of treatments have been described in the literature, however treatment is usually conservative (for example, nasal irrigation and douches; nose drops (e.g. glucose-glycerine, liquid paraffin); antibiotics and antimicrobials; vasodilators (drugs that cause dilation of blood vessels) and prostheses). Surgical treatment aims to decrease the size of the nasal cavities, promote regeneration of normal mucosa, increase lubrication of dry nasal mucosa and improve the vascularity (blood flow) of the nasal cavities.

We searched systematically for randomised controlled trials (RCTs) studying any treatment or combination of treatments for atrophic rhinitis in patients with atrophic rhinitis. Despite a comprehensive search we found no RCTs which met our inclusion criteria, although a RCT comparing surgery (Young’s operation) with nasal lubrication for primary atropic rhinitis is underway. Further high-quality research into this chronic disease, with a longer follow-up period, is therefore required to conclusively establish the long-term benefits or risks of different treatment modalities for atrophic rhinitis.