Pathophysiology of nasal congestion

Review

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Authors: Robert M Naclerio, Claus Bachert, James N Baraniuk

Published Date February 2010 Volume 2010:3 Pages 47 - 57

DOI: http://dx.doi.org/10.2147/IJGM.S8088

Robert M Naclerio¹, Claus Bachert², James N Baraniuk³

¹University of Chicago, Department of Surgery, Section of Otolaryngology – Head and Neck Surgery, Chicago, Illinois, USA; ²University of Ghent, Ghent, Belgium; ³Georgetown University, Washington, DC, USA

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.

Keywords: allergic rhinitis, congestion, obstruction, pathophysiology, rhinosinusitis