The establishment of the differential diagnosis of ozena as primary atrophic rhinitis of vascular origin and secondary atrophic rhinitis of infective source and the presentation of a definite pathologic picture for each condition have made possible a scientific approach to the therapy.
At the Third International Rhinolaryngological Congress, held in Madrid in 1932, I had the privilege of demonstrating a series of pathologic photomicrographs on the basis of which the heterogeneous group of conditions characterized by shrinkage of the expansile tissues of the nose, with increase in the nasal space, associated with fetid crusts, and commonly called synonymously atrophic rhinitis and ozena, could be separated pathologically into two subtypes. One of these (atrophic rhinitis, or secondary atrophic rhinitis) presented the pathologic picture of inflammatory reaction to infection that had invaded the tunica propria of the mucosa; the other, ozena, or primary atrophic rhinitis, was due to changes in the blood
RUSKIN SL. RATIONALE OF ESTROGEN THERAPY OF PRIMARY ATROPHIC RHINITIS (OZENA)RELATIONSHIP OF THE PHARYNGEAL PITUITARY TO OZENA. Arch Otolaryngol. 1942;36(5):632–649. doi:10.1001/archotol.1942.03760050022003