Pathophysiology of nasal congestion

Abstract

Nasal congestion is a common symptom in rhinitis (both allergic and nonallergic), rhinosinusitis and nasal polyposis. Congestion can also be caused by physical obstruction of nasal passages and/or modulation of sensory perception. Mucosal inflammation underlies many of the specific and interrelated factors that contribute to nasal congestion, as well as other symptoms of both allergic rhinitis and rhinosinusitis. A wide range of biologically active agents (eg, histamine, tumor necrosis factor-α, interleukins, cell adhesion molecules) and cell types contribute to inflammation, which can manifest as venous engorgement, increased nasal secretions and tissue swelling/edema, ultimately leading to impaired airflow and the sensation of nasal congestion. Inflammation-induced changes in the properties of sensory afferents (eg, expression of peptides and receptors) that innervate the nose can also contribute to altered sensory perception, which may result in a subjective feeling of congestion. Increased understanding of the mechanisms underlying inflammation can facilitate improved treatment selection and the development of new therapies for congestion.

Comparison of Mean Platelet Volume Values between Patients with Nasal Polyp and Healthy Individuals

“…In many adult studies, MPV is increased in atherosclerotic disorders (10,11 There are studies reporting incidence of NP as 25% in patients with allergy and the frequency of allergic rhinitis as 10-54% in patients with NP (3). It was reported that rate of allergic rhinitis is about 10-30% in general population and raises up to 45% in children (12). In our study, allergic rhinitis was seen in 50.6% of NP patients and this result was in agreement with literature.…”

A Before-after Assessment of the Efficacy of Narivent® in the Treatment of Symptoms Associated with Allergic Rhinitis in a Paediatric Population

“…Nasal congestion is a prominent and troublesome symptom of allergic rhinitis and, taking into account the pervasiveness of this condition along with other upper respiratory disorders, represents a highly prevalent problem [29].…”

Shared decision making in primary care: barriers and facilitators of shared decision making in the context of decreasing the use of unnecessary antibiotics for preschool children ages 3-5 with upper respiratory tract infections

“…Symptoms experienced during a URI are due to external factors resulting from the viral infection itself, combined with internal factors of the body's own immune response (Naclerio, Bachert, & Baraniuk, 2010;. As there are over 200 identified viruses responsible for URIs, with many similarities between viral strains, only the pathophysiology of most common cause in children, the rhinovirus, will be discussed (Lustig & Schindler, 2015).…”

“…This increases the risk of bacterial infection due to the inability of the ciliary body to remove bacteria and debris from the nose and ears, as well as allowing bacteria that colonize the nasopharynx to enter the middle ear (Vayalumkal, 2014). Pro-inflammatory cytokines are secreted which increase the inflammation of the nasal mucosa, through the stimulation of neutrophils and T helper cells (Naclerio et al, 2010). Inflammation results in increased nasal secretions, swelling of the nasal and paranasal tissues, and venous engorgement (Naclerio et al, 2010;Wilder, 2013).…”

“…Pro-inflammatory cytokines are secreted which increase the inflammation of the nasal mucosa, through the stimulation of neutrophils and T helper cells (Naclerio et al, 2010). Inflammation results in increased nasal secretions, swelling of the nasal and paranasal tissues, and venous engorgement (Naclerio et al, 2010;Wilder, 2013).…”