PATIENT EDUCATION

We all take for granted that breathing through the nose is normal to everyone. However, there are several million people who do not have the luxury of breathing through the nose. When we breathe through the nose, the air circulates through the sinuses and while passing through the sinuses the air is humidified, filtered, and brought to body temperature. The sinuses also give resonance to our voice.

Anyone with nasal obstruction, either functional or mechanical, has rhinitis. A major symptom of rhinitis in adults can be sinus headaches. These headaches are usually caused by sinus pressure and will not be shown on x-rays or CAT scans. If rhinitis persists the sinus problem will lead to fluid collection in the sinuses and ultimately turn into a sinus infection. Most people who have sinus problems do in fact have nasal obstruction, either partial or complete. Unless the nasal symptoms are cleared, the sinus problems will persist.

The most common complications of rhinitis in children include recurrent fluid collection in the ears and middle-ear infection. In this group of children, hearing loss may be significant which, in turn, can lead to learning problems in early childhood.

Patients who have chronic rhinitis also have constant post-nasal drip and frequent sore throats. Children may have an upset stomach in the morning hours because of the swallowing of mucous and increased gastric acidity.

Nasal obstruction also causes tear-duct obstruction and teary eyes. In extreme cases of nasal obstruction, people experience a loss of smell and taste. Chronic mouth breathing may cause orthodontic problems. The well-known cause of allergic shiners is due to nasal obstruction and venous congestion in the lower eyelids. A crease across the nose can be caused by constant rubbing of the nose.

Cold symptoms that last more than 10 – 14 days, often with green or yellow nasal discharge, may be due to a sinus infection.

Chronic sinusitis can cause a flare-up of asthma and bronchitis. Keeping the upper airways clear is very important in asthmatics.

There are several causes for this nasal blockage and some of the most common are described as follows:

1. Allergic Rhinitis – this is the most common cause of nasal blockage, more common in children and young adults. Allergies are less common in older people.
2. Non-Allergic Rhinitis with Eosinophils – These people have similar symptoms as people with allergies, however, the symptoms are present all year long. They respond well to the usage of steroid nasal sprays.
3. Vasomotor (non-allergic) Rhinitis – Patients with vasomotor rhinitis basically have very sensitive nasal linings and any irritants like smoke, dust, perfumes, hair sprays, cold air, temperature changes, and barometric pressure changes can aggravate symptoms. They have chronic nasal congestion and constant postnasal drip. Mot of these people ultimately end up with chronic sinus problems
4. Nasal Polyps – Nasal polyps are growths of extra tissue in the nose and allergies can aggravate them. Nasal polyps never become cancerous. These patients should be on cortisone nasal sprays to prevent recurrence.
5. Mechanical Blocking - such as Nasal Septal Deviations, Englarged Adenoids or any Foreign Bodies.
6. Rhinitis Medicamentosa – caused by excessive use of decongestant nasal sprays. This condition is most common in patients with vasomotor rhinitis.
7. Rhinitis due to infection – Rhinitis, secondary to the common cold, usually lasts 10 to 14 days and gets better.
8. Antihypertensive medications and oral contraceptives sometimes cause nasal stuffiness.

ALL PATIENTS WHO HAVE CHRONIC RHINITIS SHOULD BE EVALUATED FOR ANY OF THE ABOVE CONDITIONS. BY TREATING THE NASAL SYMPTOMS AGGRESSIVELY, WE CAN PREVENT CHRONIC SINUS PROBLEMS.