Effect of Chronic Nasal Obstruction on Pulmonary Function

Abstract

Introduction: Upper and lower respiratory diseases are closely related which has been well documented in literature. Even though a relationship between upper and lower airway disease has been described, altered pulmonary function in patients with upper airway diseases is still not fully understood. The present study was conducted to assess the effect of chronic nasal obstruction on pulmonary function and to compare the pulmonary function in same patients after surgical relief of nasal obstruction.

Elimination of nasal obstruction improves pulmonary functions and oxygenation

“…The same results were reported in previous studies [16,[20][21][22]. Cassisi et al [21] reported that nasal packing caused a significant decrease in PaO 2 , but it had little effect on PaCO 2 , and that low PO 2 returned to normal after the pack had been removed.…”

“…Ogretmenoglu et al [20] showed that nasal packing caused a significant decrease in O 2 saturation, a borderline decrease in PO2, insignificant changes in PCO 2 . Saxena et al [22] demonstrated a significant increase in partial arterial oxygen saturation percentages, as well as peak and forced expiratory flow speed in a group of patients with deviated nasal septum 1 month after the surgical correction. Mandour et al [16] reported statistically significant improvement in nocturnal oxygen in patients with nasal obstruction after surgery.…”

“…However, a The results of the current study and previous studies refer to a negative effect of nasal obstruction either pathologic or artificial by nasal packing on arterial oxygen status. This may be explained by the following: the obstructed air passage by pathologic condition and the same effect provided by the nasal packing may result in secondary hypoventilation and an increase in bronchomotor tone and activation of naso-pulmonary reflex which leads to decreased pulmonary compliance and increased pulmonary and airway resistance [21,22]. The increased bronchomotor tone led to increased turbulence, which altered the distribution of alveolar ventilation, leading to hypoxemia [21].…”

“…Besides, mechanical obstruction of the nose may activate trigeminal receptors in nasal mucosa resulting in naso-pulmonary reflex. The pressure of nasal packs may provide additional stimulation to these receptors [22]. Nasal packing causes complete nasal obstruction leading to oral breathing and may contribute to the development of sleep-disordered breathing which leads to a further decrease in oxygen saturation [24,25].…”