The nose plays a significant role in respiration (breathing) and the nasal cavity contain the sensory organs for smell. Any disorder affecting the nose can affect both smell and breathing, although the latter may not be significantly impaired as air can pass through the mouth.
Most nose problems will present with one or more of the following signs and symptoms :
- Blocked nose
- Runny Nose / Nasal discharge (rhinorrhea)
- Impaired sense of smell – complete (anosmia) or partial (hyposmia)
- Unpleasant smell (cacosmia)
- Nosebleed (epistaxis)
- Growths like a nasal polyp
- Damage and deformity of the nasal structures resulting in perforation of the septum or nasal deformity
Causes and Symptoms of Nose Problems
Most of the causes of a blocked nose are due to nasal congestion by mucus as a result of nasal inflammation. This is often a result of upper respiratory tract infections, more frequently caused by viruses. Allergic rhinitis is another common cause of a blocked nose when the hypersensitive nasal lining produces excessive amounts of mucus (hypersecretion).
Other causes of a blocked nose may be due to a nasal polyp or deviated septum, which can also impair mucus drainage from the nasal cavity.
The various causes of a blocked nose are discussed further under Rhinitis.
Nasal Discharge and Sneezing
Irritation of the nasal cavity lining often results in mucus hypersecretion. This may be a result of hypersensitivity as is seen with allergic rhinitis, infections or trauma from actions like nose picking. Exposure to airborne irritants (gas) like with smoke exposure may result in acute bouts of rhinorrhea.
In non-infectious causes, the discharge is usually clear and watery (serous) but with infections, the mucus may appear white, green or yellow. In the event of preceding head trauma followed by nasal discharge, a CSF leak should be excluded.
The sneeze reflex aims to clear out the nasal passages of any irritants. It often accompanies nasal discharge as both are common symptoms of rhinitis.
A list of causes of nasal discharge is discussed further under Runny Nose and Sneezing.
The causes of a nose bleed is discussed further under epistaxis.
Impaired Sense of Smell
The causes of anosmia (complete) and hyposmia (partial) are discussed further under the loss of sense of smell.
Cacosmia is an unpleasant smell that is persistent despite the absence of appropriate environmental stimuli. It is often a result a chronic infection with anerobic bacteria. Sometimes it is psychogenic in origin.
Other disruptions of the sense of smell like parosmia, which is the sensation of smell in the absence of any olfactory stimuli, or dysosmia, which is the distortion of smell, may be due to central disorders (affecting the central nervous system).
Pain may be related to mechanical or chemical injury to the skin, nostrils, nasal lining or nasal septum. This can range from trauma like a blow to the nose, or vigorous nose picking, to inhaling toxic fumes or snorting substances such as tobacco or cocaine. Infections may also account for pain, particularly a sinus infection or referred pain from a dental infection.
Post nasal drip can cause irritation of the throat or the mucus can enter the airways resulting thereby triggering the cough reflex.
The causes of a nasal polyp are discussed further under What is a Nasal Polyp? Nasal cavity and paranasal sinus tumors may also cause a host of symptoms including pain, discharge and impaired sense of smell.
Damage and Deformity
Deformity of the nasal structures may be apperent externally. This may be seen in trauma (‘broken nose’) or with conditions like rhinophyma. Damage and even perforation of the septum may be a result of trauma, snorting cocaine or tobacco (‘snuff’), inhaling organic and non-organic dust or granulomatous diseases.