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Nose Basics

Nose Basics

Jason Hamilton (Facial Plastic & Reconstructive Surgeon) gives expert video advice on: What are the most common nasal diseases or conditions?; Why is normal nasal function so important?; What is happening when my nose gets "stuffy"? and more...

What are the most common nasal diseases or conditions?

The most common nasal problem that patients have is allergic rhinitis, which is an allergy to either pollen or something in the environment that causes either watering, itching or obstruction of the nose. The other common nasal problem is sinusitis, where the sinuses that drain into the nose become blocked and cause pain, or are inflicted with infection.

Why is normal nasal function so important?

Normal nasal function is important because the nose serves as our humidifier for the air. When we breathe in through our nose, the air is humidified to one hundred percent by the time it reaches our voice box. Without the nose, the air remains very dry. It dries out our throat and our lungs. A proper functioning nose helps to moisturize the air that we breathe.

What is happening when my nose gets "stuffy"?

Your nose becomes stuffy because the tissue inside your nose is expansive tissue, meaning that it can increase and decrease in size based on its environment. When the nose is irritated, the tissue inside the nose swells and it blocks air from coming in. It's a protective mechanism, but it doesn't feel good because you can't breathe, so you have to breathe through your mouth and you feel like you're obstructed. The nose can react to different things in the environment, and the tissue within the nose expands and contracts based on the amount of humidity and heat in the air. If you come across an allergen that irritates the nose, this tissue swells, and the goal is to block you from breathing in more of those allergens. When the tissue in your nose is completely swollen, you can't breathe through your nose and air can't get into your lungs anymore. Your nose is trying to protect you by becoming stuff, but in an effort to protect you, you can't breathe. You sneeze because your nose is trying to protect you from irritants that are trying to get into your nose or into your throat. When your nose comes into contact with something like pollen or pepper, or something in the environment that irritates it, we sneeze to expel those things from our nose and from our air passages in order to protect us unwanted things getting into our body.

What is a "histamine"?

Histamine is a protein that's found throughout our bodies and it's usually carried in cells called mass cells. Histamines are used to dilate blood vessels and they signal our body that there's irritants around us. Histamines are actually a good thing. Patients with allergy have a hyper release of histamines. When histamines are released in large quantities, they cause itching, burning and weird swelling sensations. Histamines can affect the nose or the body in general.

What is an "antihistamine"?

Antihistamines are medications that block or bind the histamine receptors on cells. Antihistamines protect your body from releasing histamine when they come in contact with an allergen. By blocking the histamine release, you prevent the symptoms that are associated with it, such as itching, runny nose or stuffiness, that are associated with common allergies.

What is a "decongestant"?

Decongestants are medications that shrink tissues in the nose. They can be in an oral form, such as Sudafed, or they can be in the form of nasal sprays, such as Neo-Synephrine or Afrin. Decongestants work on the blood vessels to kind of decrease the amount of blood flow to an area. By doing that, the tissue that those blood vessels supply shrinks, and it allows you to be decongested and breathe better.

What is "post-nasal drip"?

Post-nasal drip is caused by mucus and secretions in the nose that don't come out of the front of the nose but down the back. Post-nasal drip is usually thicker secretions than normal secretions, that come out of the front of the nose and usually run down the back of your throat. They land on your voice box and try to get into your lungs, and that's why you cough. It's very irritating and it can commonly be treated with antihistamines or nasal sprays.

What is "mucus"?

Mucus is a naturally occurring substance that lines mucus membranes in our nose, throat and throughout our body. The mucus is produced to prevent these mucus membranes from becoming dry. The mucus also catches irritants in the environment and coalesces them into a group. They're either swallowed when they pass through the back of your nose, or if you have a cold, you blow them out.

What is "rhinitis"?

Rhinitis is inflammation of the lining of the nose. It's different from sinusitis, which involves the sinus cavities themselves. Rhinitis is commonly caused by either a viral infection or an allergic reaction where the tissues of the nose swell. They secrete more mucus. They become boggy and irritated; and they also obstruct your breathing.

What are "nasal polyps"?

Nasal polyps are caused by a blockage of the mucus glands in the nose. Over time, with constant irritation, these glands kind of swell and expand. The mucosa of the nose actually forms these outcroppings, or swellings, that kind of grow out of the nose and block off the nasal passages. Typically they're seen in patients who have allergies, but they can also be seen in patients who have chronic sinus infections as well. Nasal polyps are usually a sign of some kind of disease that involves the body. In children, polyps can be a sign of cystic fibrosis, where patients have a problem with the mucus that they produce in their body; it's too thick. Due to the fact that the mucus is thick, they have constant irritation; they form polyps. So, that may be the first sign in a child that they have cystic fibrosis; it can be very serious. In an adult, polyps are usually a sign of chronic allergy. If the polyps are removed but the allergy is not treated, they'll come back. In general, polyps are not dangerous, but they need to be treated, and the primary cause of the polyp needs to be discerned. Polyps are usually treated surgically, and if the polyps only involve the nose, they can be removed with a snare, they can be removed with special instruments like scissors, or they can be removed endoscopically, with minimum basic surgery. If the polyps involve the sinuses, then the patient would need a sinus surgery to remove the polyps from the sinuses as well. People who have nasal polyps may require three, four, or five sinus surgeries in their lifetime, because the polyps continue to come back.

What is a "nosebleed" and what should I do if I get one?

Nosebleeds are usually caused by drying of the nasal lining. When the nasal lining becomes dry, the blood vessels that supply the nose become cracked and they bleed. Nosebleeding can either be from the front of the nose, and you'll see the blood come out, or can it be in the back of the nose, where the blood runs down into the throat.