Nose Disorders

The nose serves several important functions. Not only is it one of the most prominent facial features, impacting voice tone, but it also filters air entering the lungs, aids in our sense of smell, and protects against infection. Therefore, disorders of the nose can significantly impact an individual's quality of life. Common nasal disorders include rhinitis, sinusitis, nasal polyps, snoring, nosebleeds, cancer, and deviated septum. Most nasal disorders are treatable with proper diagnosis and medical care.

Rhinitis occurs when mucous membranes in the nose become inflamed, often in response to the body's release of histamine secondary to airborne irritants such as allergens. The increased inflammation and fluid production in the nasal passages may cause breathing difficulties. Rhinitis has two basic causes: [Page 1252](1) viral infection or (2) allergies, both with similar symptoms. The most common symptom is a runny nose, but others include congestion, postnasal drip, cough, sneezing, or itchiness in the nasal passages.

Sinusitis may be acute or chronic and occurs when the sinus passages are blocked for an extended time, which causes swelling in the sinus lining and nasal congestion.

Sinusitis often occurs with rhinitis, and may be either bacterial or viral. Chronic sinusitis may increase risk of nasal polyps (small growths in the nasal passages). A rhinoscope (flexible fiber optic camera for looking in the nose) may be used for diagnosis, especially if there is suspicion of nasal polyps.

Nasal polyps are growths occurring in the nares created by chronic swelling/inflammation. Smaller polyps can be a minor bother, but larger ones can impede breathing and sense of smell. Polyps can also increase frequency of headaches or initiate snoring problems. Nasal polyps are more frequently seen in individuals with chronic sinus infections, asthma, cystic fibrosis, and hay fever, and can be successfully removed through surgery.

Snoring is a sign of obstructed breathing occurring during sleep. Air flow is obstructed where the tongue and upper throat meet the soft palate and uvula. The audible noise of snoring results from vibration of these structures, and can disturb sleep patterns and cause sleep deprivation.

Many factors are associated with snoring, including poor muscle tone, congested nasal passages, or nasal deformities. Mild snoring may be prevented by changes in lifestyle such as proper diet and exercise, establishing regular sleep habits, and avoiding heavy meals and alcohol before bed. However, chronic snorers may require further medical evaluation to rule out a more serious condition.

Nosebleeds commonly occur in the front of the nose and are usually not serious, stopping quickly. Most severe nosebleeds are due to trauma, and some result from damage to large vessels in the back of the nose. Larger vessel nosebleeds can also result from high blood pressure, atherosclerosis, daily aspirin use or bleeding disorders and are more common among the elderly.

Other factors that affect nosebleeds are acute or chronic infections, polyps, nose picking, or the inhalation of irritating substances. Medical treatment for nosebleeds may include application of epinephrine to the nose, gauze packing, or a nasal balloon catheter. Antibiotics may be appropriate if packing is required for greater than a 24-hour period. Frequent nosebleeds may be the symptom of a more serious problem and should receive medical evaluation.

...