Angie Houtz
Memorial Scholarship Fund

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How to Care of Your Nose?

What is our nose?

The nose constitutes the entrance of the air to the upper respiratory tract.

The upper part of the nose or nasal bridge is composed of the nasal bones, the part of the top jaw and the nasal part of the frontal bone. That is, it is bony. In contrast, the lower portion of the nose is formed by cartilage.

Inside the nose is the nasal septum, which is partly bone and part cartilaginous, and divides the nasal cavity into the two nostrils, the holes located above the mouth. These open to the outside by two openings called nostrils or nostrils, which are limited by the wings of the nose and, inside, are connected to the pharynx by two posterior holes, called choanae.

Also, on the side walls of the nostrils are spongy bones called turbinates. Under each corneal, there are spaces called meats, which are those that communicate the nose with the paranasal sinuses.

Inside, the nostrils have hair, short and thick, called nasal vibrissae, which serve to filter the inspired air. By coating the internal walls, there are also secretory mucous cells, to which the dust particles that enter with the inspired air adhere.

More profoundly, the nasal passages are covered by the pituitary, which has two regions, yellow and red. The yellow pituitary, of only about 2 square centimeters in area, is formed by sensitive cells, capable of capturing the thousands of odors present in the air. These cells are connected to the central nervous system, to which they send these olfactory sensations.

On the other hand, the red pituitary is covered by a large number of blood vessels, and it is the part of the nose that warms and moistens the air we breathe.

Why we need our nose?

The nose constitutes the entrance of the air to the upper respiratory tract. That is, it is the organ that allows us to breathe. Also, it filters this air to eliminate dust, germs and any irritating particles it may contain. Subsequently, it heats and moistens it to prevent the lungs and the tubes that lead to them from drying out.

The nose is also the organ of smell. It can perceive up to ten thousand different odors, thanks to the fact that microscopic hairs called cilia cover the nerve cells it contains. When the molecules of the smell that transports the air enter through the nose, they stimulate the cilia, which begin to produce nervous signals. Subsequently, the olfactory nerve transmits these signals to the olfactory bulb, which is located in the upper part of the nasal cavity, below the front of the brain. The latter is responsible for interpreting the nerve signals and identify the corresponding smell.

Finally, the nose also helps to enhance the sense of taste.

What problems affect the nose?

We all know the most frequent problems of the nasal cavity, such as allergies, colds, infections or other conditions that can make the nose work less efficiently and does not fulfill its functions. When this happens, the whole body suffers, because the difficulties from breathing appear, it rests worse, and the welfare of the organism is affected.

But other diseases threaten nasal health, among which are:

  • Nasal polyps. These are inflamed tissue masses similar to sacs that form in the lining of the nose or paranasal sinuses. If they are large, they can block the latter or the nasal airway and produce nasal congestion, sneezing, headaches and, sometimes, loss of sense of smell and taste. They seem to grow due to prolonged inflammation and irritation in the nose caused by allergies, asthma or infections. Some medications such as antihistamines or certain aerosols can relieve symptoms, but surgery can only remove large polyps.

  • Deviated nasal septum. It is one of the most frequent problems of the nose is the deviation of the wall that divides the nasal cavity into two halves. Although it may be present from birth, it usually occurs as a result of a blow or nasal trauma or by the overgrowth of the cartilage. The primary symptom is the nasal obstruction on the side where the deviation is found, although nosebleeds, headache or nasal obstruction can also occur on the side opposite to the variation. The treatment consists of surgery called septoplasty, although it is only recommended in case of obstructive symptoms.

  • Fractures and nasal traumas. The nose is the most prominent part of the face, so it is not surprising that nasal fractures are the most common facial skeleton. These nasal traumas are usually caused by traffic and sports accidents, assaults or accidental blows.

  • Sinusitis. The paranasal sinuses are cavities filled with air, which are found in the face and skull and communicate with the nose. These holes serve to heat the air we breathe. When the inflammation of the mucosa that covers these cavities occurs, it is what we call sinusitis.

The causes of sinusitis are very diverse:

  • Anatomical causes: caused by or a deviated septum or enlarged turbinates in the nose.
  • Motivated by lifestyle: include pregnancy, working with children and smoking.
  • Inflammatory and infectious causes: related to bacterial, viral and fungal infections, as well as allergies and polyps.
  • Developmental disorders: such as cystic fibrosis.

Commonly, sinusitis manifests with pressure and facial pain, abundant mucous, nasal obstruction, cough and weakness in the sense of smell; although fever, pain in the teeth or mouth and difficulty in breathing may also occur. When the symptoms last less than three weeks, there is the talk of acute sinusitis, if they continue between three weeks and three months, subacute, and if the disease persists for more than three weeks, it is considered a chronic sinusitis.

Hyposmia and anosmia. They are two disorders related to the sense of smell. Hyposmia is when the ability to detect odor is reduced, and anosmia is when this feeling disappears entirely, and the person cannot catch any scent. The causes that trigger these problems are traumatic brain injuries (blows to the head) or a typical process such as an infection of the respiratory tract. Also, rhinitis, nasal congestion, and nosebleeds are two of the problems related to the nose that occurs most among the population. They appear detailed below:

What is rhinitis?

Many people think that the nose is congested due to excess thick mucus. However, in most cases, congestion of the nose occurs when the tissues that cover it become inflamed due to an enlargement of the blood vessels. At a therapeutic level, that inflammation is called rhinitis.

Rhinitis has a very different origin and includes different factors. It can be allergic, infectious, by drugs, hormonal, occupational, etc. The most common is that of allergic etiology, which affects 21.5% of the Spanish population, having a more significant impact on the child population. This type of rhinitis can be classified as intermittent or persistent; and according to its severity in mild, moderate or severe, taking into account the symptoms and their impact on the quality of life.

Thus, the characteristic symptomatology of a rhinitis is based on the appearance of two or more of the following manifestations:

  • Rhinorrhea (anterior and posterior): emission of sufficient flow through the nose.
  • Sneezes.
  • Nasal obstruction, and nasal itching for 2 or more consecutive days and more than 1 hour on most days.

All of them can be accompanied by ocular, optic and pharyngeal symptoms, depending on the cause that causes it. The conjunctivitis allergic is highly prevalent and has a close relationship with rhinitis. Thus, it is common for these two processes to be associated with 60-80% of cases.

It may also be accompanied by psychosocial and cognitive symptoms: fatigue, depression, irritability, anxiety, sleep disturbance, disturbance of concentration, difficulty in learning, in decision-making, reduction of psychomotor speed.

Although if the origin of rhinitis is banal, it is enough to go to the pharmacist for a therapeutic recommendation, yes that there are some cases of rhinitis in which the best way to act is to go to the doctor for the evaluation:

  1. Children under two years of age, pregnant women and nursing mothers
  2. People with associated systemic problems: heart disease or bronchopathy (including asthma and COPD).
  3. Patients who use nasal decongestants very frequently.
  4. Lack of response to the measures proposed by the pharmacist within 3-5 days.
  5. In people in whom there is no improvement of the symptoms to the initial treatment suggested in the pharmacy in a period of between 2 and four weeks.
  6. In case of moderate or severe persistent rhinitis (the pharmacist can provide initial treatment while the patient waits to be seen by the doctor).
  7. For symptoms that suggest undiagnosed asthma, or inadequate control in patients diagnosed with asthma (for example, whistling in the chest or sensation of suffocation).
  8. In cases in which the patient presents symptoms of infection (mucopurulent secretions, sore throat, myalgia, asthenia, fever).
  9. In cases in which the patient has bothersome side effects. Cases of chronic rhinitis, whatever their origin, should be referred to the doctor.

What is nasal congestion?

The nasal congestion is the feeling of difficulty passing air through the nostrils. A virus or bacteria usually cause it, and the origin ranges from a common cold, flu or sinus infection. The congestion often disappears by itself after a week.

When is it necessary to go to the doctor?

Experts recommend going to the doctor if the nose secretion smells terrible, comes from only one side or is a different color from white or yellow. It is also necessary to see a doctor if a fever accompanies the discharge, there is a cough that produces a yellow-greenish or gray mucus, or the symptoms of nasal congestion last more than three weeks.

In case of nosebleeds, the doctor should be consulted if it does not stop after twenty minutes, if the bleeding occurs after a head injury or if there is a suspicion that the nose may be broken (for example, it is deformed after a hit). Finally, if the nosebleeds become frequent, are repetitive or are not related to a cold or other minor irritation, it is also necessary to seek medical attention. The health personnel will perform a physical examination of the respiratory tract, the ears, the nose, and throat and, if necessary, skin tests for allergies and blood tests, as well as cultures of the sputum and throat, and an x-ray of the paranasal sinuses and thorax.

Do babies need specialized care for the nose?

Up to six months of age, babies are not able to breathe through their mouth, as their airways have not fully matured. Although breathing through the nose is the healthiest and most natural way to do it, because it is responsible for moistening, heating and filtering the air, any obstruction in the nose can prevent the baby from breathing correctly, as well as causing difficulties in sleeping or feeding.

Therefore, it is crucial to keep the baby’s nasal passages clean and free of mucus. To do this, when they have a lot of mucus or have difficulty breathing, it is recommended to perform nasal washes with saline to dissolve the mucus and drag them. To achieve this, you should administer some drops in each nostril and then gently aspirate the mucus with a rubber bulb or a specific aspirator.

The physiological saline can be found in single-dose or aerosol containers. As it is a very annoying process for the baby, it is better to do it after the bath, when the water vapor has softened the mucus, and the little one is relaxed.

During the operation, do not put under any circumstances objects in the baby’s nostrils, not even the applicator of the spray or cotton swabs.