Which one of the following is a cause of nasal obstruction in Atrophic Rhinitis:

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* Young's 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.