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The Nasal Airway

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Sleep Disordered Breathing in Children

Part of the book series: Respiratory Medicine ((RM))

Abstract

The anatomy and physiology of the nose will be discussed in detail in this chapter. The nose is an intricate organ with important functions, which include filtration, humidification, and temperature control of inspired air in preparation for transit to the lower airways. It is also important in providing the sense of olfaction and sensory irritation. It has an intricate network of nerves, vessels, glands, and inflammatory cells that all help to modulate its function. This chapter also discusses some evidence that supports the importance of the nasal airway as a contributor to sleep-disordered breathing in children.

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References

  1. Van Loosen J, Van Zanten GA, Howard CV, et al. Growth characteristics of the human nasal septum. Rhinology. 1996;34:78–82.

    PubMed  Google Scholar 

  2. Mygind N, Pedersen M, Nielsen M. Morphology of the upper airway epithelium. In: Proctor DF, Andersen IB, editors. The nose. Amsterdam: Elsevier Biomedical Press BV; 1982.

    Google Scholar 

  3. Maniscalco M, Sofia M, Pelaia G. Nitric oxide in upper airways inflammatory diseases. Inflamm Res. 2007;56:58–69.

    Article  PubMed  CAS  Google Scholar 

  4. Lindberg S, Cervin A, Runer T. Low levels of nasal nitric oxide (NO) correlates to impaired mucociliary function in the upper airways. Acta Otolaryngol. 1997;117:728–34.

    Article  PubMed  CAS  Google Scholar 

  5. Evans MJ, Plopper CG. The role of basal cells in adhesion of columnar epithelium to airway basement membrane. Am Rev Respir Dis. 1988;138:481–3.

    Article  PubMed  CAS  Google Scholar 

  6. Tos M. Goblet cells and glands in the nose and paranasal sinuses. In: Proctor DF, Andersen IB, editors. The nose. Amsterdam: Elsevier Biomedical Press BV; 1982.

    Google Scholar 

  7. Winther B, Innes DJ, Mills SE, et al. Lymphocyte subsets in normal airway mucosa of the human nose. Arch Otolaryngol Head Neck Surg. 1987;113:59–62.

    Article  PubMed  CAS  Google Scholar 

  8. Bradding P, Feather IH, Wilson S, et al. Immun­olocalization of cytokines in the nasal mucosa of normal and perennial rhinitic subjects. J Immunol. 1993;151:3853–65.

    PubMed  CAS  Google Scholar 

  9. Lim MC, Taylor RM, Naclerio RM. The histology of allergic rhinitis and its comparison to cellular changes in nasal lavage. Am J Respir Crit Care Med. 1995;151:136–44.

    PubMed  CAS  Google Scholar 

  10. Varney VA, Jacobson MR, Sudderick RM, et al. Immunohistology of the nasal mucosa following allergen-induced rhinitis. Am Rev Respir Dis. 1992;146:170–6.

    PubMed  CAS  Google Scholar 

  11. Bojsen-Moller F. Glandulae nasales anteriores in the human nose. Ann Otol Rhinol Laryngol. 1965;74:363–75.

    PubMed  CAS  Google Scholar 

  12. Cauna N. Blood and nerve supply of the nasal lining. In: Proctor DF, Andersen IB, editors. The nose. Amsterdam: Elsevier Biomedical Press BV; 1982.

    Google Scholar 

  13. Baroody FM, Wagenmann M, Naclerio RM. A comparison of the secretory response of the nasal mucosa to histamine and methacholine. J Appl Physiol. 1993;74(6):2661–71.

    PubMed  CAS  Google Scholar 

  14. Baraniuk JN, Lundgren JD, Okayama M, Mullol J, et al. Substance P and neurokinin A in human nasal mucosa. Am J Respir Cell Mol Biol. 1991;4:228–36.

    PubMed  CAS  Google Scholar 

  15. Baraniuk JN, Lundgren JD, Goff J, Mullol J, Castellino S, Merida M, et al. Calcitonin gene related peptide in human nasal mucosa. Am J Physiol. 1990;258:L81–8.

    PubMed  CAS  Google Scholar 

  16. Laitinen A, Partanen M, Hervonen A, et al. VIP-like immunoreactive nerves in human respiratory tract. Light and electron microscopic study. Histochemistry. 1985;82:313–9.

    Article  PubMed  CAS  Google Scholar 

  17. Baraniuk JN, Lundgren JD, Okayama M, et al. Vasoactive intestinal peptide (VIP) in human nasal mucosa. J Clin Invest. 1990;86:825–31.

    Article  PubMed  CAS  Google Scholar 

  18. Wilson WR, Allansmith MR. Rapid, atraumatic method for obtaining nasal mucus samples. Ann Otol Rhinol Laryngol. 1976;85:391–3.

    PubMed  CAS  Google Scholar 

  19. Andersen I, Lundqvist G, Proctor DF. Human nasal mucosal function under four controlled humidities. Am Rev Respir Dis. 1972;106:438–49.

    PubMed  CAS  Google Scholar 

  20. Fry FA, Black A. Regional deposition and clearance of particles in the human nose. Aerosol Sci. 1973;4:113–5.

    Article  Google Scholar 

  21. Lippmann M. Deposition and clearance of inhaled particles in the human nose. Ann Otol Rhinol Laryngol. 1970;79:519–22.

    PubMed  CAS  Google Scholar 

  22. Proctor DF. The mucociliary system. In: Proctor DF, Andersen IB, editors. The nose: upper airway physiology and the atmospheric environment. Amsterdam: Elsevier Biomedical Press BV; 1982.

    Google Scholar 

  23. Hasegawa M, Kern EB. The human nasal cycle. Mayo Clin Proc. 1977;52:28–34.

    PubMed  CAS  Google Scholar 

  24. Kennedy DW, Zinreich SJ, Kumar AJ, et al. Physiologic mucosal changes within the nose and the ethmoid sinus: imaging of the nasal cycle by MRI. Laryngoscope. 1988;98:928–33.

    Article  PubMed  CAS  Google Scholar 

  25. Swift DL, Proctor DF. Access of air to the respiratory tract. In: Brain JD, Proctor DF, Reid LM, editors. Respiratory defense mechanisms. New York, NY: Marcel Dekker; 1977.

    Google Scholar 

  26. Ingelstedt S, Ivstam B. Study in the humidifying capacity of the nose. Acta Otolaryngol. 1951;39:286–90.

    Article  PubMed  CAS  Google Scholar 

  27. Aharonson EF, Menkes H, Gurtner G, et al. Effect of respiratory airflow rate on removal of soluble vapors by the nose. J Appl Physiol. 1974;37:654–7.

    PubMed  CAS  Google Scholar 

  28. Scherer PW, Hahn II, Mozell MM. The biophysics of nasal airflow. Otolaryngol Clin North Am. 1989;22:265–78.

    PubMed  CAS  Google Scholar 

  29. Ingelstedt S, Ivstam B. The source of nasal secretion in normal condition. Acta Otolaryngol. 1949;37:446–9.

    Article  Google Scholar 

  30. Togias AG, Proud D, Lichtenstein LM, et al. The osmolality of nasal secretions increases when inflammatory mediators are released in response to inhalation of cold, dry air. Am Rev Respir Dis. 1988;137:625–9.

    PubMed  CAS  Google Scholar 

  31. Rouadi P, Baroody FM, Abbott D, Naureckas E, Solway J, NAclerio RM. A technique to measure the ability of the human nose to warm and humidify air. J Appl Physiol. 1999;87:400–6.

    PubMed  CAS  Google Scholar 

  32. Assanasen P, Baroody FM, Abbott DJ, Naureckas E, Solway J, Naclerio RM. Natural and induced allergic responses increase the ability of the nose to warm and humidify air. J Allergy Clin Immunol. 2000;106:1045–52.

    Article  PubMed  CAS  Google Scholar 

  33. Assanasen P, Baroody FM, Naureckas E, Solway J, Naclerio RM. The nasal passage of subjects with asthma has a decreased ability to warm and humidify inspired air. Am J Respir Crit Care Med. 2001;164:1640–6.

    PubMed  CAS  Google Scholar 

  34. Berglund B, Lindvall T. Olfaction. In: Proctor DF, Andersen IB, editors. The nose. Amsterdam: Elsevier Biomedical Press BV; 1982.

    Google Scholar 

  35. Rous J, Kober F. Influence of one-sided nasal respiratory occlusion on the olfactory threshold values. Arch Klin Exp Ohren Nasen Kehlkopfheiklk. 1970;196(2):374–7.

    Article  CAS  Google Scholar 

  36. Ship JA, Pearson JD, Cruise LJ, et al. Longitudinal changes in smell identification. J Gerontol. 1996;51(2):M86–91.

    CAS  Google Scholar 

  37. Zwillich CW, Pickett C, Hanson FN, Weil JV. Disturbed sleep and prolonged apnea during nasal obstruction in normal men. Am Rev Respir Dis. 1981;124(2):158–60.

    PubMed  CAS  Google Scholar 

  38. Olsen KD, Kern EB, Westbrook PR. Sleep and breathing disturbance secondary to nasal obstruction. Otolaryngol Head Neck Surg. 1981;89(5):804–10.

    PubMed  CAS  Google Scholar 

  39. Lavie P, Fischel N, Zomer J, Eliaschar I. The effects of partial and complete mechanical occlusion of the nasal passages on sleep structure and breathing in sleep. Acta Otolaryngol. 1983;95:161–6.

    Article  PubMed  CAS  Google Scholar 

  40. Taasan V, Wynne JW, Cassisi N, Block AJ. The effect of nasal packing on sleep-disordered breathing and nocturnal oxygen desaturation. Laryngoscope. 1981;91(7):1163–72.

    Article  PubMed  CAS  Google Scholar 

  41. Johannessen N, Jensen PF, Kristensen S, Juul A. Nasal packing and nocturnal oxygen desaturation. Acta Otolaryngol Suppl (Stockh). 1992;492:6–8.

    Article  CAS  Google Scholar 

  42. White DP, Cadieux RJ, Lombard RM, Bixler EO, Kales A, Zwillich CW. The effects of nasal anesthesia on breathing during sleep. Am Rev Respir Dis. 1985;132(5):972–5.

    PubMed  CAS  Google Scholar 

  43. Wilhoit SC, Suratt PM. Effect of nasal obstruction on upper airway muscle activation in normal subjects. Chest. 1987;92(6):1053–5.

    Article  PubMed  CAS  Google Scholar 

  44. Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleep-disordered breathing. The university of Wisconsin sleep and respiratory research group. J Allergy Clin Immunol. 1997;99(2):S757–62.

    Article  PubMed  CAS  Google Scholar 

  45. Young T, Finn L, Palta M. Chronic nasal congestion at night is a risk factor for snoring in a population-based cohort study. Arch Intern Med. 2001;161(12):1514–9.

    Article  PubMed  CAS  Google Scholar 

  46. Meljeteig H, Hoffsten V, Cole P. The effect of unilateral and bilateral nasal obstruction on snoring and sleep apnea. Laryngoscope. 1992;102(10):1150–2.

    Article  Google Scholar 

  47. Assanasen P, Baroody FM, Naureckas E, Solway J, Naclerio RM. Supine position decreases the ability of the nose to warm and humidify air. J Appl Physiol. 2001;91:2459–65.

    PubMed  CAS  Google Scholar 

  48. Bousquet J, Van Cauwenberge P, Khaltaev N. Aria workshop group; world health organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001;108 Suppl 5:S147–334.

    Article  PubMed  CAS  Google Scholar 

  49. Wallace DV, Dykewicz MS. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008;122:S1–84.

    Article  PubMed  Google Scholar 

  50. Shedden A. Impact of nasal congestion on quality of life and work productivity in allergic rhinitis. Findings from a large online survey. Treat Respir Med. 2005;4:439–46.

    Article  PubMed  Google Scholar 

  51. McNicholas WT, Tarlo S, Cole P, Zamel N, Rutherford R, Griffin D, Phillipson EA. Obstructive apneas during sleep in patients with seasonal allergic rhinitis. Am Rev Respir Dis. 1982;126(4):625–8.

    PubMed  CAS  Google Scholar 

  52. Craig TJ, Teets S, Lehman EB, Chinchilli VM, Zwillich C. Nasal congestion secondary to allergic rhinitis as a cause of sleep disturbance and daytime fatigue and the response to topical nasal corticosteroids. J Allergy Clin Immunol. 1998;101(5):633–7.

    Article  PubMed  CAS  Google Scholar 

  53. Meltzer EO, Munafo DA, Chung W, Gopalan G, Varghese ST. Intranasal mometasone furoate therapy for allergic rhinitis symptoms and rhinitis-disturbed sleep. Ann Allergy Asthma Immunol. 2010;105(1):65–74.

    Article  PubMed  CAS  Google Scholar 

  54. Bixler EO, Vgontzas AN, Lin HM, Liao D, Calhoun S, Vela-Bueno A, Fedok F, Vlasic V, Graff G. Sleep-disordered breathing in children in a general population sample: prevalence and risk factors. Sleep. 2009;32(6):731–6.

    PubMed  Google Scholar 

  55. McColley SA, Carroll JL, Curtis S, Loughlin GM, Sampson HA. High prevalence of allergic sensitization in children with habitual snoring and obstructive sleep apnea. Chest. 1997;111:170–3.

    Article  PubMed  CAS  Google Scholar 

  56. Chng SY, Yam Thiam Goh D, Wang XS, Tan TN, Bee Hwa Ong N. Snoring and atopic disease: a strong association. Pediatr Pulmonol. 2004;38:210–6.

    Article  PubMed  Google Scholar 

  57. Brouillette RT, Manoukian JJ, Ducharme FM, et al. Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea. J Pediatr. 2001;138:838–44.

    Article  PubMed  CAS  Google Scholar 

  58. Mansfield LE, Diaz G, Posey CR, et al. Sleep-disordered breathing and daytime quality of life in children with allergic rhinitis during treatment with intranasal budesonide. Ann Allergy Asthma Immunol. 2004;92:240–4.

    Article  PubMed  CAS  Google Scholar 

  59. Sullivan S, Li K, Guilleminault C. Nasal obstruction in children with sleep-disordered breathing. Ann Acad Med Singapore. 2008;37:645–8.

    PubMed  Google Scholar 

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Correspondence to Fuad M. Baroody MD, FACS .

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Baroody, F.M. (2012). The Nasal Airway. In: Kheirandish-Gozal, L., Gozal, D. (eds) Sleep Disordered Breathing in Children. Respiratory Medicine. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-725-9_4

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  • DOI: https://doi.org/10.1007/978-1-60761-725-9_4

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  • Publisher Name: Humana Press, Totowa, NJ

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  • Online ISBN: 978-1-60761-725-9

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