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Published January 25, 2012, 11:30 PM

Mathison: What you need to know about your nose

Tis the season … for coughing, sneezing, colds, nosebleeds, flu and sinus infections.

By: Dr. Susan Mathison, Areavoices blogger, INFORUM

Tis the season … for coughing, sneezing, colds, nosebleeds, flu and sinus infections.

The medical office is really busy at this time of year, and we are not immune at our house either. My 4-year-old son Grant let out a really big sneeze and had long globs of mucous hanging out each nostril. He looked like a mini-walrus with tusks and thought it was really funny. Thankfully, we got a tissue before this big mess ended up on his sleeve.

It always helps to know what’s going on up there, in the mysterious territory of your nose. Your nose is your personal filtration system, the gatekeeper and defender of your airways.

The external structure of the nose can affect how it functions internally, something we surgeons keep in mind when doing rhinoplasty.

The internal state of your nose can make or break your day. We all know how awful if feels to have a congested nose, which leads to poor sleep, dry throat and a foggy head.

The nasal cavity is divided by the septum, which is made of cartilage in the front and bone in the back. The septum is the main culprit for nosebleeds, and 90 percent come from the front.

There are also projections from the side walls of the nose, called turbinates. Ever wonder why our noses run when we cry? The tear ducts drain into the nose underneath the inferior turbinates. The middle turbinate covers the opening to the maxillary (cheek) sinuses, and the superior turbinate is just below the bone protecting our brains.

All interior nasal structures are lined with mucous membranes, which can expand and contract. Since the nose’s main functions are to filter, warm and humidify the air that passes through, these adjustments by expansion and contraction help to adjust the temperature of the incoming air.

You may have noticed that sometimes you breathe better on one side of your nose than the other. If you are always more restricted on one side, it may mean that your nasal septum is crooked and partially blocks one side of your airway.

If airflow seems to change from side to side, you are aware of the natural cycle of your nose, with one side providing adequate passage of air, while the other does the filtering.

If both sides are blocked over a few days, it can be due to viral or bacterial infections or allergies. If they always seem blocked, it could be due to year-round allergies or even nasal polyps, which are jelly-like mounds of swollen tissue blocking the nose and sinus cavities.

In rare cases, nasal cancers can present with chronic blockage, so if you really have trouble breathing through your nose, it’s a good idea to get checked by your doctor. Sometimes we can identify the problem by looking carefully with our special lights. CT scans are useful for a deeper evaluation if necessary.

The membranes secrete about one pint of mucous on a normal day. The cells also have hair-like projections called cilia, which help to move particles and pollens away from your nose. The cilia are stunned by cigarette smoke and other toxins and impaired by allergies, increasing the likelihood of nasal problems.

I could write a book of practical tips for a healthy and beautiful nose, but here’s a few to get you started:

1. Wash your hands. Most bacteria and viruses get into our nose by direct contact.

2. Use a humidifier if your nose feels dry. Nosebleeds occur because we develop tiny cracks in the mucosal surface on our septum.

If you do get a nosebleed, pinch the lower soft part of your nose, NOT the bony bridge, for 10 minutes. Lean forward so the blood doesn’t trickle down your throat, which can lead to nausea. This usually works, but if it is still oozing, moisten a small portion of a cotton ball with Afrin nasal spray (or the generic equivalent) and tuck that inside your nostril. Hold for another 10 minutes.

Get checked by your doctor if it’s still going. Aspirin, fish oil supplement and high blood pressure make nosebleeds more of a risk.

3. Use nasal saline mist, like Ocean, Ayr or Simply Saline to keep nasal passages moist. If you’re congested, try a hypertonic (concentrated) rinse like NasoPure, NeilMed or a neti pot, if you can get the hang of it. Use clean water, of course. I think the squirt bottles are easier than the neti pot.

Many saline rinse kits come with pre-made salt and sodium packets. If you’d rather make your own, use one teaspoon of pickling or canning salt (not iodized table salt) and ½ teaspoon baking soda in 8 ounces of clean water. If it is safe to drink, it’s likely safe for rinses.

You may have read however, that nationally there were two deaths late this summer linked to neti pot usage, where an amoeba infested the water supply. Thankfully, this organism is not found in our region, but boil then cool the water if you’d like.

4. Look at underlying factors. Stop smoking if you do, stay away from second- and third-hand smoke. Check into allergy evaluation to see if allergies are part of the problem.

5. Consider some alternatives like Xylitol (Xclear) nasal rinses, probiotocs and Manukah honey, if you are infection prone.


Dr. Susan Mathison founded Catalyst Medical Center in Fargo and created PositivelyBeautiful.com.

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