Nasal Congestion: Pathophsiology, Causes, Clinical Features & Treatment

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Nasal congestion is also known as nasal blockage, nasal obstruction, plugged nose, blocked nose etc. Nasal means Nose while Congestion means an abnormal accumulation of fluid in the nasal cavity.

It is a symptom complex of many diseases in which the passage of air through the nose is reduced/obstructed resulting in difficulty in breathing. The severity of congestion varies depending upon its cause and ranges from minor irritability to life-threatening conditions.

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PATHOPHYSIOLOGY 

It arises from the engorgement of blood vessels due to the effect of vasoactive mediators and the neural stimuli. Parasympathetic innervation dilates the blood vessels and enhances the nasal congestion.

CAUSES OF NASAL CONGESTION

There are various causes of nasal congestion some of the common causes are listed below:

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  1. Common Cold /Acute rhinitis
  2. Allergic rhinitis
  3. vasomotor rhinitis
  4. Nasal polyposis
  5. Deviated  nasal  septum
  6. Sinusitis 
  7. Pregnancy
  8. Narrow nasal valve
  9. Rhinitis medicamentosa

    Isolating the exact causes helps in providing the correct medications if required. Nasal congestion is one of the most frequently found cases in the ENT outdoors.

 CLINICAL FEATURES

     Clinical features vary according to the cause and age of the patient suffering from Nasal congestion. Nasal congestion interferes with the breastfeeding in neonates and causes life-threatening respiratory distress. In adults, it may be limited to a source of irritability.

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It is due to adenoid may lead to snoring, sleep apnea and even Right-sided heart failure. Surgical removal of Adenoid relieve the symptoms. 

It may also cause hearing loss and speech difficulties. 

TREATMENT  

  1. Drug therapy is not always indicated.In many cases, nasal congestion relieves spontaneously within a week.
  2. Home remedies like Steam inhalation and nasal irrigation are very useful.
  3. Medications are normally started when the patients complaints of decreased sleep, and developing sleep apnea.
  4. Alpha-adrenergic drugs remain the first choice. It helps in constriction of blood vessels thereby relieving the congestion. Alpha-adrenergic is oxymetazoline, Phenylephrine etc.
  5. Paracetamol, Ibuprofen and aspirin can be given to relieve the symptoms.
  6. Allergic congestions can be avoided by staying away from the offending allergens.
  7. Topical decongestants are of great help.
  8. In neonates, nasal aspiration of the mucus is very effective.

Sound Therapy (Binaural Beats) To Clear Nasal Congestion

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