Contrary to normal beliefs, blowing one's nose is not helpful at all times. Of course it does help remove some secretions and alleviate nasal stuffiness, but when done during sinusitis and rhinitis it causes more harm than help. Let us see how is this true.
Entire nasal cavity is lined by cells (the mucosa) which are covered on top by mucus fluid (nasal secretions). These cells have cilia (long projections) which beat in a single direction and propel the secretions towards the nasopharynx (back of nose). From the nasopharynx, the secretions fall backwards and downwards into the throat.
Paranasal sinuses are air filled cavities in the surrounding bones that open into the nasal cavity. These sinuses open via ostia, which are small holes (small in relation to the size of sinuses). These sinuses are also lined by mucosa and covered by mucus. Here, the mucus flows from inside the sinus to outside (nasal cavity) through the particular ostium. The sinuses are ventilated through the same ostia when you exhale air (during breathing out).
- When you blow your nose, the intranasal pressure increases manifold and the secretions go back into the sinuses. When this occurs in the setting of rhinitis or sinusitis, it introduces nasal fluid containing viruses, bacteria, and inflammatory mediators into the sinuses.
- Blowing-generated increased pressures cause decrease in viscosity of mucus. This makes the mucus susceptible to bubble formation. Such bubble formation does not occur normally.
One might then ask, so the same should happen during coughing and sneezing. Surprisingly, no. Coughing and sneezing are protective reflexes and the rise in intranasal pressures during these two are only a tenth of the rise during nose blowing. Consequently, coughing and sneezing neither cause bubble formation nor backflow of mucus into the sinuses.
So, what exactly should be done during rhinitis or sinusitis when you feel the urge to blow your nose ?? Try HAWKING. Hawking is clearing the throat by forcing up the phlegm. If it is too congested, put few drops of decongestant nasal spray and rest for 10 minutes. Thereafter do steam inhalation and hawk and spit out the secretions which come to throat. But remember not to hawk very frequently, that those near you might wonder if something is wrong with you :)
Consult an ENT otolaryngologist online for queries regarding sinusitis --> https://www.icliniq.com/ask-a-doctor-online/ENT-Otolaryngologist
