Nasal Congestion

Nasal Congestion

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The three most common reasons for nasal congestion are your nasal anatomy, nasal allergies or chronic sinusitis (sinus disease). This video will explain how each of these could be causing nasal congestion or the sensation of congestion.

Video Transcription

Hello, I’m doctor Ludwick, and we’re going to talk about the basic causes of nasal congestion. 

 

There are three main causes of nasal congestion. 

 

The first being your nasal anatomy, the second being nasal allergies, and the third thing is chronic sinusitis or sinus disease. 

 

Let’s talk about nasal anatomy. 

 

Looking at a cross-section of the face, this represents the natural anatomy of the nose and sinus. This box represents the nasal cavity. This is where we move the air through our nose. And inside this box is the septum, which is the wall that divides our nose into two separate sides: the right side and the left side. 

 

nasalcavitybox

 

If you have a deviated septum or septal deformity, what that means is that your septum is not in the middle like it’s supposed to be, but rather there are deviations or deflections, or deformities that are causing obstruction of one side or the other, or potentially both sides. 

 

And because those obstructions are there, when you try to breathe through that side of your nose, the air doesn’t move very freely through your nose. 

 

Inside the nose, we also have something called the turbinate. Now, why do we want to breathe through our nose? We want to breathe through our nose because it’s comfortable and the nose does three things for us:

 

 1. 

It warms the air

2.

It humidifies the air, and

3.

It cleans the air

 

And the reason it can do that for us is because we have turbinates. 

 

So what is a turbinate? A turbinate is an organ in our nose that adds a lot of surface area to the nose cavity. Look at all that surface area that a turbinate adds to our nasal cavity. 

 

turbinate 

 

If you were to turn the head sideways, you’d see that this turbinate actually extends the entire length of the nasal cavity.

 lengthofturbinate

 

We have a lower turbinate, and we have a middle turbinate. Air does not go through the nose like we think. Our nose goes straight through our head, and the air comes across the nose, and as the air passes over those high area surface structures (turbinates), water can efficiently evaporate. 

 

These turbinates are full of blood that is stored in erectile tissue. And that erectile tissue, like other erectile tissue we have, can swell sometimes. And if it swells, they take up a lot more room in the nasal cavity and creates nasal congestion. And that’s why patients really like things like Afrin and Sudafed or other decongestants because what those products do is squeeze the blood out of the turbinate to allow us to breathe better.

 

The first cause that we’ll summarize is anatomy — either a bad septum or big turbinates. 

 

The second reason we can have nasal congestion are nasal allergies. I’m sure most people are aware of nasal allergies. That’s the itching, sneezing, nasal drainage, itchy, watery nose and eyes that we can get. 

 

Nasal allergies are caused by things in the air, that land inside our nose, and create a lot of inflammation. That inflammation takes up a lot of space and also causes a lot of leaky vessels that cause drainage, itchy, and sneezing. 

 

We definitely want to control allergies when we’re talking about improving nasal congestion. 

 

The third thing that can cause nasal congestion is sinuses. The sinuses are these bony rooms of air around the face. 

 

sinusareas

 

Nasal allergies are caused by things in the air, that land inside our nose, and create a lot of inflammation. That inflammation takes up a lot of space and also causes a lot of leaky vessels that cause drainage, itchy, and sneezing. 

 

We definitely want to control allergies when we’re talking about improving nasal congestion. 

 

The third thing that can cause nasal congestion is sinuses. The sinuses are these bony rooms of air around the face.

 

We have many sinuses, and all these sinuses have to ventilate with the nasal cavity — so that’s the relationship between the sinus and the nose. It’s ventilation. They’re separate organs, but they’re related through this need of the sinus to ventilate.

 

The sinuses, as I mentioned, are lined with this thin skin. If this thin skin becomes inflamed, chronically inflamed, that’s called chronic sinusitis. 

 

When the mucosa of the nasal cavity is inflamed chronically, it gives you the sensation like there’s something in there, you can’t blow it out. It gives you the sensation of congestion. This is the third main reason that patients suffer from nasal congestion. 

 

While these aren’t the only reasons patients suffer from nasal congestion, they are the most common. 

 

 

 

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