In spite of a large number of researches and publications, rhinologists have not yet come to a definite agreement as to the etiology of ozena. Numerous theories have been advanced without, however, any one of them being adequate to explain all cases. One thing seems to be certain, i.e., ozena has become rarer since the almost routine removal of tonsils and adenoids and the better attention given to suppurating sinusitis. Even in large clinics, one is struck by the scarcity of this once fairly frequent disease.
The most characteristic symptom of ozena is the offensive, penetrating and nauseating odor, not perceived by the patient on account of the anosmia that is usually present. Even the cause of the production of the fetor is not quite clear. Bacteriology is not able to settle this question. It is difficult to determine whether the bacteria are the direct cause of the atrophy
HUBERT L, ROBINSON GA. RADIUM THERAPY IN ATROPHIC RHINITIS WITH OFFENSIVE ODOR (OZENA). Arch Otolaryngol. 1929;10(2):166–170. doi:10.1001/archotol.1929.00620050062004
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