Function of the Turbinates: Nasal Cycle
Respiratory function of the nose is to sufficiently condition the respirated air which is maintained by supplying the mucosa with thermal energy and fluid for humidification. This is supplied by the blood circulation and in coherence with the nasal cycle
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Rainer K. Weber and Jochen A. Werner
Keywords
Nasal cycle • Inferior turbinate • Nasal airway resistance • Nasal physiology • Turbinate surgery
Core Messages
• Spontaneous changes in nasal airway resistance in the two separate nasal passages due to congestion and decongestion of nasal venous sinuses are called nasal cycle. One respiratory function of the nose is to sufficiently condition the respirated air which goes along with the nasal cycle.
R.K. Weber, MD (*) Department of Otorhinolaryngology, Head and Neck Surgery, Rhinology Center Marburg, University Hospital Marburg UKGM, Baldinger Straße, D-35043 Marburg, Germany e-mail: [email protected], rainerweber@ rainerweber.de J.A. Werner, MD Department of Otolaryngology, Head and Neck Surgery, Rhinology Center Marburg, University Hospital Marburg UKGM, Marburg, Germany e-mail: [email protected]
• It is important to consider the nasal cycle and other physiologic changes in the congestion of the nasal mucosa when making a clinical assessment of a patient complaining of nasal obstruction. The indication for surgery should be based on clinical history, on examination by anterior rhinoscopy and nasal endoscopy, and by considering these physiologic variations in addition to measurements of nasal airway patency. Long-term rhinoflowmetry offers a new possibility for investigating nasal patency for up to 72 h.
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Definition of Nasal Cycle
The respiratory function of the nose is to sufficiently condition the respirated air which is maintained by supplying the mucosa with thermal energy and fluid for humidification. This is supplied by the blood circulation and in coherence with the nasal cycle (Grützenmacher et al. 2005). The erectile tissue enables the turbinates to cyclically congest and decongest. One side of
T.M. Önerci (ed.), Nasal Physiology and Pathophysiology of Nasal Disorders, DOI 10.1007/978-3-642-37250-6_21, © Springer-Verlag Berlin Heidelberg 2013
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the nose is in its working phase conditioning the air, with an unimpeded air passage and increased turbulence. At the same time, the contralateral side is in its resting phase, saving energy and moisture by high airway resistance and low turbulence (Lang et al. 2003). The airflow through the nose is regulated by the activity of the erectile venous tissue of the nasal mucosa (Eccles 1982). The nasal epithelium has a very complex vascular nature with a submucosal plexus of venous sinuses lining the nasal mucosa. These venous sinuses from erectile tissue are well developed in the anterior part of the nasal septum and the inferior turbinate (Hanif et al. 2000). These submucosal cushions of the venous sinuses expand and shrink depending on the degree of congestion, hence altering the calibre of the nasal passages and influencing the nasal airflow. An enlargement of this tissue leads to a reduction of the nasal lumen and increases the flow resistance. The cyclic congestion and decongestion of the nasal mucosa is called nasal cycle (Eccles 1982) and is observed in about 80 % of the people (
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