Unilateral nasal discomfort? Maybe you need to be more vigilant than bilateral nasal discomfort! |Science popularization time

"Doctor, my wife and I may have caught a cold recently. We have stuffy noses, runny noses, and occasional nosebleeds. My wife has symptoms on both sides of his nose. The strange thing is that my left nose has symptoms, and the right nose is normal. "In the outpatient clinic, the patient Lao Zhang described his condition to me.

Hearing this, I immediately became alert and asked him: "Did the right nose have symptoms at the beginning and then got better, or was there no discomfort from the beginning to the end?"

Lao Zhang replied that he had always had symptoms on the left side of his nose, but had never had any discomfort on the right side.

After careful examination, it was discovered that Lao Zhang did not have a cold at all, but a benign nasal tumor, an inverted papilloma.

It can be seen that unilateral nasal discomfort is not a trivial matter, it may even be a major matter!

what is the root cause? We know that common sinus diseases can be divided into two major categories. One category is inflammatory diseases, including acute rhinitis, chronic sinusitis, nasal polyps, etc. They have a common feature, that is, most of them are bilateral nasal cavity lesions. When a person has a cold or a rhinitis attack, the severity of the symptoms in both sides of the nasal cavity may be different, but both sides must feel uncomfortable. Another type of disease is unilateral nasal cavity disease, which is clinically referred to as unilateral nasal cavity and sinus disease. These diseases are mainly tumor diseases, but also include some special infections or tumor-like diseases.

So, what are the warning signs of unilateral nasal cavity and sinus disease?

Nasal congestion is one of the most common symptoms of nasal disease. The well-known chronic rhinitis, allergic rhinitis, sinusitis, deviated nasal septum, etc. can all cause bilateral nasal congestion. Bilateral nasal congestion may occur at the same time or alternately. Because the mucosal structure of both nasal cavities is the same, when bacteria or allergens enter the nasal cavity, the nasal mucosa on both sides will be irritated and cause symptoms. However, if it is a unilateral nasal obstruction, it means that the disease only occurs in one side of the nasal cavity. Then the cause is often not exogenous stimulation such as bacteria or allergens, but endogenous factors originating in the nasal cavity.

Therefore, unilateral nasal obstruction prompts us to consider the possibility of developing nasal cavity and sinus tumors. Common benign and malignant tumors in the nasal cavity and sinuses, such as inverted papilloma, squamous cell carcinoma, lymphoma, etc., one of the first symptoms is unilateral nasal obstruction.

Epistaxis is one of the common emergencies of the nose, which can occur in people of all ages and is more common in the elderly and children. In mild cases, it may only show blood in the tears, while in severe cases, it may cause hemorrhagic shock.

The causes of epistaxis are complex, including not only local factors in the nasal cavity, but also some systemic factors. The guidelines for the diagnosis and treatment of nosebleeds formulated by domestic scholars point out that nosebleeds in adults are often related to factors such as cardiovascular disease, the use of nonsteroidal anti-inflammatory drugs, and alcohol abuse. In children, nosebleeds are more common in dryness of the nasal cavity, allergies, foreign bodies in the nasal cavity, and blood. Systemic diseases, kidney diseases, dietary problems, etc.

It can be seen that nose bleeding is an important warning sign of abnormality in the body, and different manifestations of nose bleeding indicate different health problems. For example, if there is a small amount of blood in the nasal cavity or blood in the nose, it occurs alternately on both sides or mainly on one side. The bleeding occurs once or twice a day or once every few days. The amount of bleeding is small. You can use local pressure on the affected side of the nose or stuffing cotton balls. By applying pressure to stop the bleeding, the bleeding can be controlled in ten minutes... This kind of performance is usually bleeding in the front of the nasal cavity. Most of the patients are children. It is often caused by dry nasal mucosa, frequent nose rubbing or nose picking.

If epistaxis in elderly patients often occurs at night, it is often related to unstable blood pressure control or long-term oral anticoagulants. If a male in adolescence has a nosebleed with a large amount of bleeding and the nasal cavity on the side of the bleeding is often blocked, he should be alert to the occurrence of nasopharyngeal fibroangioma.

When most people have headaches, doctors will first consider problems in the skull. However, it is also common for unilateral nasal cavity and sinus lesions to cause headaches and head and face pain. Many diseases that occur in the sinuses can easily involve or invade the skull base and orbit, causing headache symptoms, such as fungal sinusitis, sinus mucocele, etc. Since there are abundant sensory nerve endings in the sinus mucosa, under the stimulation of inflammation and tumors, people will experience swelling and pain in the head and face.

Different from headaches caused by other causes, headaches caused by unilateral nasal cavity and sinus lesions have certain characteristics. For example, headaches are often mainly on one side, and the location is not fixed. They can be located on the face, forehead, temporal or occipital area on one side. The pain is mainly dull pain, swelling pain, and dull pain, and rarely throbbing or pins and needles. Pain, the pain is not severe but lasts for a long time. Therefore, it is strongly recommended that headache patients must not ignore nasal and sinus problems while ruling out intracranial diseases.

The olfactory function is one of the important functions of the nasal cavity. If you have long-term hyposmia on one or both sides, or even complete loss of smell, you must go to the hospital because it may indicate the occurrence of nasal polyps or nasal tumors.

Scholars at home and abroad have long discovered that hyposmia is one of the four most common symptoms of chronic sinusitis and nasal polyps, and many patients cannot recover their sense of smell. Clinical observations have also found that the probability of recovery of olfactory function is inversely proportional to the duration of olfactory impairment, that is, the longer the olfactory loss, the lower the possibility of recovery.

Some patients have a normal sense of smell, but often smell a foul smell in their nasal cavity or nasal mucus. This symptom is highly suggestive of the possibility of odontogenic sinusitis. The maxillary sinus floor has a very close relationship with the alveolar bone and tooth roots. Many root apical lesions can cause sinusitis, which is called odontogenic sinusitis.

Just like the patient Lao Zhang mentioned at the beginning of the article, many people think that it is better to have problems with one side of the nasal cavity than problems with both sides of the nasal cavity. This is a misunderstanding.

If it is a bilateral nasal lesion caused by common rhinitis, patients may be able to prevent and treat it by ensuring a long rest period, improving the body's immunity, and developing good hygiene habits.

However, these measures are obviously not enough for unilateral sinonasal lesions. Patients must go to a regular hospital as soon as possible to determine the cause of the disease through nasal endoscopy or imaging examinations, and receive standardized treatment.

Author: Tian Hao, Center of Otolaryngology-Head and Neck Surgery, Beijing Friendship Hospital Affiliated to Capital Medical University

Review: Liu Yuhe, expert in the National Health Science Expert Database and chief physician of the Otolaryngology-Head and Neck Surgery Center of Beijing Friendship Hospital Affiliated to Capital Medical University