<prompt> Which one of the following is a cause of nasal obstruction in Atrophic Rhinitis:SecretionsDeviated nasal septumPolypCrusting  <response>: Ans. d CrustingRef: Dhingra 5th Ed. . 170ATROPHIC RHINITIS OZAENA Etiology Remember Mnemonic HERNIA Hereditary factors Endocrinal disturbance: Disease usually starts at puberty, involves females more than males. Racial factors: White and yellow races are more susceptible than equatorial African natives. Nutritional deficiency. Disease may be due to deficiency of vitamin A, D or iron Infective. Kelbsiella ozaenae: most common cause Diphtheroids, R vulgaris, Esch. coli, staphylococci and StreptococciClinical Features Foul smell from the nose Merciful anosmia Nasal obstruction: Due to large crusts filing the nose Epistaxis: may occur when the crusts are removedTreatmentMedical: Nasal irrigation and removal of crusts by Alakaline Douche- Best Treatment Alakaline nasal douche is prepared from in ratio of 1:1:2: Sodium bicarbonate Sodium biborate Sodium chlorideSurgical Youngs operation: Both the nostrils are closed completely just within the nasal vestibule by raising flaps. They are opened after 6 months. Modified young operation: To avoid the discomfort of bilateral nasal obstruction, modified Youngs operation aims to partially close the nostrils. 