Nose and Throat Conditions of Breathing

Nasal Air Flow

Nasal breathing is more comfortable than mouth breathing, and while we are sleeping, the mouth may close, leaving us with only a nasal airway. Broken down into components, there are several factors that can contribute to nasal airway resistance, including the following:

1. Deviated nasal septum

2. Allergies

3. Enlarged turbinates

4. Nasal polyps 

5. Sinus infection

6. Nasal valve collapse

7. Nasal septal perforation

8. Enlarged adenoids (especially in children)

• Animated video demonstrating common causes of nasal airflow problems.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a condition in which the upper airway becomes blocked during sleep such that despite attempts to breathe, air is not passed to the lungs, leading to a dangerous condition before awakening and resuming airflow. This can happen hundreds of times a night. Unfortunately, obstructive sleep apnea is a common dangerous problem, and it is definitely present in unsuspecting individuals, including children and adults.

Snoring

If the upper airway is partially blocked, snoring can occur. While snoring is a risk factor for obstructive sleep apnea, and most people with obstructive sleep apnea do snore, simple snoring without obstructive sleep apnea can still be a nuisance that impairs sleep of the individual and their bed partner.

Laryngeal (Voice Box) Causes of Breathing Difficulty

After the nostrils, the larynx (voice box) is he narrowest part of the airway. In adults, the space between the vocal cords is the narrow area, whereas in children, it’s just below the vocal cords, in an area called the subglottis or cricoid. Swelling due to inflammation or growths here can cause significant constriction of the airway. In adults, tumors, polyps, and dysfunction of the nerve(s) controlling the vocal cords are common laryngeal causes of breathing difficulty. In children, croup or viral growths (papillomas) are more common. Swelling of the flap above the vocal cords (the epiglottis) can progress into airway distress fairly quickly in a condition called epiglottitis. Before a vaccine for the bacterium Haemopholis influenzae type B was developed in the 1980s, this condition was much more common. In non-vaccinated individuals, this infection remains a risk. Epiglottis can still occur in immunized individuals, though much less commonly, when a different bacterial infection causes swelling of the epiglottis. Croup, also known as laryngotracheobronchitis, is an infection of the airway mainly below the vocal cords, and since children have a narrowing in is area more than adults, the characteristic barking cough of croup is more commonly associated with children. Since croup is most often caused by the influenza virus, the parainfluenza virus, and the diphtheria bacterium, immunization against these organisms (DPT or diphtheria, pertussis, and tetanus vaccine and the Hib vaccine against bacteria Haemopholis influenzae type B) reduces the risk of croup significantly among those immunized. Laryngospasm is a condition in which the vocal cords involuntarily close in response to something touching them. This is a protective reflex to prevent food or liquid from passing down to the lungs and causing a pneumonia but for a brief period when the vocal cords are closed, breathing is very difficult and noisy, and the affected individual may become anxious.

Tracheal (wind pipe) causes of breathing difficulty

Compression or narrowing of the wind pipe can occur from a variety of causes, including narrowing of the inner diameter (swelling of the lining of the trachea, a tumor of the trachea, or constriction of the lining due to scar formation called tracheal stenosis), compression from outside the trachea (due to a growth of the thyroid or a lymph node, for example), blockage of the lumen (due to foreign bodies or a large piece of solid mucus), and tumors of the trachea itself.

The lower airway, including asthma

The connection between the upper airway (mouth, nose, throat) and the lower airways (trachea, lungs) is more than just a passageway for airflow. Bacteria, viruses, and inflammation travel up and down as well. Sinus infections can worsen asthma or other lung problems. Diagnosis of the root cause or its contributors of lung problems may be tricky, and, especially when not responding to a typical treatment, may prompt looking higher (or lower) in the airways.