From the Guidelines
Sinonasal physiology is a complex process involving the normal functioning of the nasal cavity and paranasal sinuses, which work together to filter, warm, and humidify inhaled air, with the sinuses producing mucus that drains into the nasal cavity through the ostia, and any obstruction of these ostia can lead to mucous impaction, decreased oxygenation, and potentially serious complications 1. The sinonasal physiology is characterized by the presence of ciliated columnar epithelium and goblet cells in the sinuses, which sweep mucus toward the ostial opening, and the blood flow in the maxillary sinus is roughly estimated to be 100 mL/100 g tissue per minute, similar to that found in the nose but higher than that found in the brain. Some key points about sinonasal physiology include:
- The sinuses are air-filled cavities with classical, pseudostratified, ciliated columnar epithelium interspersed with goblet cells
- The cilia sweep mucus toward the ostial opening, and obstruction of the ostia can lead to mucous impaction and decreased oxygenation in the sinus cavities
- The anatomic arrangement of the sinuses makes the frontal anterior ethmoid and maxillary sinuses dependent on the ostiomeatal complex for their ventilation and mucociliary clearance
- Significant obstruction of this complex can predispose to the development of sinusitis, as noted in the study published in the Journal of Allergy and Clinical Immunology 1. The importance of understanding sinonasal physiology lies in its relationship to various sinonasal disorders, such as sinusitis, rhinitis, and other conditions that can arise from disruptions to the normal functioning of the nasal cavity and paranasal sinuses, and the study provides valuable insights into the diagnosis and management of these conditions 1.
From the Research
Sinonasal Physiology Overview
- Sinonasal physiology refers to the normal functioning of the nasal cavity and paranasal sinuses, which includes the production and drainage of mucus, as well as the maintenance of nasal airflow and pressure.
- The sinonasal area is a complex structure that plays a crucial role in respiratory function, olfaction, and immune defense, as noted in studies such as 2.
- Anatomical variations of the sinonasal area can affect its physiology and increase the risk of sinus disease, as discussed in 2.
Nasal Function and Mucociliary Transport
- Nasal function and mucociliary transport are essential components of sinonasal physiology, as they help to clear mucus and debris from the nasal cavity, as studied in 3.
- The use of medications such as clarithromycin and fluticasone propionate can improve nasal function and mucociliary transport in patients with chronic rhinosinusitis, as shown in 3.
- However, the effectiveness of topical corticosteroids in treating chronic rhinosinusitis is still a topic of debate, with some studies showing no significant benefit, as reported in 4 and 5.
Treatment and Management
- Treatment of sinonasal physiology disorders often involves a combination of medical and surgical interventions, as discussed in 6.
- The use of fluticasone propionate nasal drops can reduce the need for sinus surgery in patients with nasal polyposis and chronic rhinosinusitis, as demonstrated in 6.
- Further research is needed to fully understand the effects of anatomical variants on sinonasal physiology and to develop effective treatment strategies, as highlighted in 2.