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Nose Disease: Overview and Treatment

Nose Disease
Contents

Overview

The nasal cavity is made up of two passages separated by the nasal septum, a wall of cartilage and bone. In front, they open to the outside through the nostrils. In back, they open into the upper throat (nasopharynx) through openings called choanae.

The side wall of each nasal passage is uneven. It has three (sometimes four) curled, bony shelves covered with moist lining, called turbinates: the inferior, middle and superior turbinates, and sometimes a supreme turbinate.

The space under each turbinate is called a meatus, and this is where the paranasal sinuses drain into the nose. Paranasal sinuses are air-filled spaces in the bones of the face. They develop through childhood and connect to the nasal passages. They include:

  • Maxillary sinus: two large cavities in the cheekbones, below the eyes;
  • Frontal sinus: irregularly shaped, in the forehead bone above the root of the nose;
  • Ethmoid cells: a network of small air cells between the eyes, forming the two ethmoid labyrinths;
  • Sphenoid sinus: deep behind the nose, in the center of the skull.

Nasal functions are different:

  • Respiratory function: The nose filters, warms and humidifies the air you breathe before it reaches the lungs;
  • Olfactory action: smell is handled by special nerve-rich lining (olfactory epithelium) in the roof of each nasal passage;
  • Defensive function: nose hairs, mucus and tiny hair-like cilia trap and clear dust, particles and germs.

4 Major Nose Disease

Here are 4 major nose diseases and their explanation:

1- Rhinitis

Rhinitis means inflammation of the lining of the nose. The most common form of acute rhinitis is the common cold. It is caused by viruses, especially rhinoviruses and parainfluenza viruses, and causes a lot of nasal discharge and congestion. Thick, discolored mucus can occur with colds and does not by itself mean a bacterial infection.

Structural problems can make nasal blockage worse. These include a deviated septum, enlarged inferior turbinates or an air-filled middle turbinate.

Another common type is allergic rhinitis, also called hay fever when pollen is the trigger. It is an immune reaction to allergens. Seasonal allergens include pollen, and year-round (perennial) allergens include dust mites and pet dander.

Symptoms include a stuffy nose, clear runny nose, sneezing, itchy nose and a reduced sense of smell. Many people also have itchy, watery eyes (allergic conjunctivitis).

According to MedlinePlus, allergic rhinitis is diagnosed with a history and exam, and skin testing is the most common allergy test. Blood tests can be used when skin tests aren’t possible. Treatments include avoiding triggers, saline rinses, antihistamines and nasal steroid sprays, which are the most effective option. Allergy shots or under-the-tongue (sublingual) immunotherapy can help when symptoms are hard to control.

2- Sinusitis

Sinusitis is inflammation of the lining of the sinuses. MedlinePlus defines three types by how long symptoms last. Acute sinusitis lasts 4 weeks or less. Subacute sinusitis lasts 1 to 3 months. Chronic sinusitis lasts longer than 3 months. Sinusitis can be viral, bacterial or, less often, fungal.

Many factors can contribute, such as colds, allergies, a deviated septum, nasal polyps, a weak immune system and dental infections. The most common symptoms are thick nasal discharge, congestion, facial pain or pressure over the affected sinus, and a reduced sense of smell.

3- Nasal polyp

Nasal polyps are soft, painless growths on the lining of the nose or sinuses. They are not cancer. They seem to develop from long-term inflammation.

MedlinePlus lists risk factors such as asthma, chronic sinus infections, hay fever, aspirin sensitivity and cystic fibrosis. Polyps are also linked to a rare condition called eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome). A polyp on only one side should be checked by a doctor, because it can occasionally be a different kind of growth.

A person with nasal polyps may have a blocked or runny nose, a reduced or lost sense of smell or taste, snoring and a change in voice.

4- Fractures of the nasal bones

Because the nose sticks out, it is often injured in falls, sports and fights. A broken nose is one of the most common facial fractures. It can cause nosebleeds, swelling, bruising, trouble breathing and sometimes other facial fractures.

A doctor may be able to move the broken bones back into place, usually within the first 2 weeks after the injury. After that, the bones start to heal in their new position.

If the nose heals crooked, the deformity can later be corrected with rhinoplasty. Get care right away if blood collects inside the septum (septal hematoma), if bleeding won’t stop or if clear fluid drains from the nose. Never try to straighten a broken nose yourself.

Treatment Of Nose Disease

Treatment depends on the cause. Common options include:

Nasal corticosteroid:

These nasal sprays help prevent and treat inflammation. Examples include fluticasone, triamcinolone, budesonide, mometasone and beclomethasone. If sprays aren’t enough, a doctor may recommend saline rinses, sometimes with budesonide added. Saline nasal irrigation rinses out mucus, allergens and irritants.

Oral or injected corticosteroids:

These drugs are used to relieve inflammation from severe sinusitis, especially if you also have nasal polyps. Oral corticosteroids can cause serious side effects when used over a long period of time, so they are used only to treat severe symptoms.

Aspirin desensitization:

Some people with nasal polyps, asthma and aspirin sensitivity have a condition called aspirin-exacerbated respiratory disease. Under close medical supervision, a specialist may give gradually larger doses of aspirin to build tolerance. Never try this on your own.

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Conclusion

  • The nose filters, warms and humidifies the air you breathe and gives you your sense of smell. The sinuses drain into the nose through small openings under the turbinates. Common nose diseases include rhinitis, sinusitis, nasal polyps and nasal fractures. See a doctor for symptoms that last more than a few weeks, keep coming back or follow an injury.

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