Nasal Airflow and Health: Physiological Mechanisms, Clinical Consequences, and the Role of Rhinoplasty
Main Article Content
Abstract
Airflow through the nasal passages is crucial for comfortable breathing, conditioning the air we inhale, and maintaining overall health. Limited airflow can cause obstructive sleep apnea, worsen asthma, raise cardiovascular stress, and lead to cognitive issues. Conversely, improving nasal airflow enhances sleep quality, exercise capacity, lung function, and mental well-being. Addressing both anatomical and structural matters, functional rhinoplasty is a key surgical procedure that can restore nasal airflow. This comprehensive review highlights the importance of rhinoplasty in improving both function and appearance by presenting the latest research on how nasal airflow affects physiology and clinical results. It includes patient surveys, such as the NOSE and SNOT-22 scales, as well as objective tests, such as rhinomanometry and acoustic rhinometry. This article explores how nasal airflow impacts overall health by examining airflow physiology, the effects of obstruction, and surgical correction options.
Keywords:
Nasal Airflow, Rhinoplasty, Nasal patency, nasal surgery
Article Details
How to Cite
ÖZDEMIR, Erdi; SÜNNETCI, Gürcan; CINGI, Cemal.
Nasal Airflow and Health: Physiological Mechanisms, Clinical Consequences, and the Role of Rhinoplasty.
Medical Research Archives, [S.l.], v. 13, n. 11, nov. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7029>. Date accessed: 26 dec. 2025.
doi: https://doi.org/10.18103/mra.v13i11.7029.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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9. Andre RF, Vuyk HD, Ahmed A, Graamans K, Nolst Trenité GJ. Correlation between subjective and objective evaluation of the nasal airway: A systematic review. Clin Otolaryngol. 2009;34(6):518-525.
10. Ciprandi G, Mora F, Cassano M, Gallina AM, Mora R. Oral breathing and chronic rhinitis in children. Allergy Asthma Proc. 2011;32(6):23-29.
11. Konstantinidis I, Triaridis S, Triaridis A, Karagiannidis K, Kontzoglou G. Long-term results following nasal septal surgery. Rhinology. 2005;43(2):109-114.
12. Craig TJ, Teets S, Lehman EB, Chinchilli VM. Nasal congestion secondary to allergic rhinitis is a cause of sleep disturbance and daytime fatigue. Allergy Asthma Proc. 1998;19(1):23-29.
13. Schwitzer JA, Yu P, Hatef DA, Izaddoost S, Yellin SA. Nasal function and aesthetics: A comprehensive review of functional rhinoplasty. Plast Reconstr Surg. 2015;135(2):356-371.
14. Meltzer EO. Intranasal corticosteroids: Current and new treatments. Clin Allergy Immunol. 2007;19:127-154.
15. Eccles R. Nasal airflow in health and disease. Acta Otolaryngol. 2000;120(5):580-595.
16. Welge-Lüssen A, Wolfensberger M. Olfactory disorders following upper respiratory tract infections. Adv Otorhinolaryngol. 2006;63:125-132.
17. Fokkens WJ, Lund VJ, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps. Rhinology. 2012;50(Suppl 23):1-298.
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19. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230-1235.
20. Pang KP, Cheong RCT, Lim JW, et al. Nasal surgery is pivotal, not primary, in OSA surgery—a 25-year evidence-based systematic review. Eur Arch Otorhinolaryngol. Published online July 23, 2025. doi:10.1007/s00405-025-09553-z
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23. Erdogan M, Cingi C, Seren E, et al. Evaluation of nasal airway alterations associated with septorhinoplasty by both objective and subjective methods. Eur Arch Otorhinolaryngol. 2013;270(1):99-106.
24. Yağci ZG, Bayar Muluk N, Yazir M, et al. The reasons why individuals who have facial aesthetics constantly want more and more. J Craniofac Surg. 2025; doi:10.1097/SCS.0000000000011610.
25. Xavier R, Azeredo-Lopes S, Menger DJ, Carvalho HC, Spratley J. Comparative functional effect of alternative surgical techniques used in rhinoplasty. Ann Otol Rhinol Laryngol. 2023;132(6):638-647.
26. Rhee JS, Arganbright JM, McMullin BT, Hannley MT. Evidence supporting functional rhinoplasty or nasal valve repair: A 25-year systematic review. Otolaryngol Head Neck Surg. 2008;139(1):10-20.
27. Tomljenović D, Grgurić L, Knežević M, et al. Comparing Nasal Patency Outcomes in Patients Undergoing Septoplasty with Radiofrequency Turbinate Reduction, Turbinectomy, or Valvuloplasty: A Prospective Cohort Study. Medicina (Kaunas). 2025;61(9):1656. Published 2025 Sep 11. doi:10.3390/medicina61091656
28. Wong B, Heppt W, Twu CJ. Cosmetic Rhinoplasty and Nasal Obstruction: What I Look for, How Do I Evaluate the Patient. Facial Plast Surg Clin North Am. 2024;32(4):447-457. doi:10.1016/j.fsc.2024.06.003
29. Xavier R, Shandilya M. Objective Outcome Measures in Nasal Valve Repair and Nasal Obstruction. Otolaryngol Clin North Am. 2025;58(2):215-226. doi:10.1016/j.otc.2024.08.006
2. Lundberg JO, Weitzberg E, Nordvall SL, Kollberg H, Alving K. Primarily nasal origin of exhaled nitric oxide and absence in Kartagener’s syndrome. Eur Respir J. 1994;7(8):1501-1504.
3. Rhee JS, Weaver EM, Park SS, et al. Clinical consensus statement: Diagnosis and management of nasal valve compromise. Otolaryngol Head Neck Surg. 2010;143(1):48-59.
4. Li HY, Wang PC, Chen YP, Chen NH, Lee LA, Fang TJ. Critical appraisal and meta-analysis of nasal surgery for obstructive sleep apnea. Am J Rhinol Allergy. 2011;25(1):45-49.
5. Camacho M, Zaghi S, Certal V, et al. Nasal dilators (internal and external) for obstructive sleep apnea: A systematic review and meta-analysis. Sleep Breath. 2016;20(2):597-602.
6. Friedman M, Tanyeri H, Lim J, et al. Effect of improved nasal breathing on obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000;122(1):71-74.
7. Eccles R. The role of the nasal airway in exercise. Am J Rhinol. 1992;6(2):97-101.
8. Sipilä J, Suonpää J. A prospective study using rhinomanometry and patient satisfaction in septal surgery. Arch Otolaryngol Head Neck Surg. 1997;123(2):112-115.
9. Andre RF, Vuyk HD, Ahmed A, Graamans K, Nolst Trenité GJ. Correlation between subjective and objective evaluation of the nasal airway: A systematic review. Clin Otolaryngol. 2009;34(6):518-525.
10. Ciprandi G, Mora F, Cassano M, Gallina AM, Mora R. Oral breathing and chronic rhinitis in children. Allergy Asthma Proc. 2011;32(6):23-29.
11. Konstantinidis I, Triaridis S, Triaridis A, Karagiannidis K, Kontzoglou G. Long-term results following nasal septal surgery. Rhinology. 2005;43(2):109-114.
12. Craig TJ, Teets S, Lehman EB, Chinchilli VM. Nasal congestion secondary to allergic rhinitis is a cause of sleep disturbance and daytime fatigue. Allergy Asthma Proc. 1998;19(1):23-29.
13. Schwitzer JA, Yu P, Hatef DA, Izaddoost S, Yellin SA. Nasal function and aesthetics: A comprehensive review of functional rhinoplasty. Plast Reconstr Surg. 2015;135(2):356-371.
14. Meltzer EO. Intranasal corticosteroids: Current and new treatments. Clin Allergy Immunol. 2007;19:127-154.
15. Eccles R. Nasal airflow in health and disease. Acta Otolaryngol. 2000;120(5):580-595.
16. Welge-Lüssen A, Wolfensberger M. Olfactory disorders following upper respiratory tract infections. Adv Otorhinolaryngol. 2006;63:125-132.
17. Fokkens WJ, Lund VJ, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps. Rhinology. 2012;50(Suppl 23):1-298.
18. Ciprandi G, Mora F, Cassano M, Gallina AM, Mora R. Oral breathing and chronic rhinitis in children. Allergy Asthma Proc. 2011;32(6):23-29. (duplicate of #10; kept once but shown here because in original list)
19. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230-1235.
20. Pang KP, Cheong RCT, Lim JW, et al. Nasal surgery is pivotal, not primary, in OSA surgery—a 25-year evidence-based systematic review. Eur Arch Otorhinolaryngol. Published online July 23, 2025. doi:10.1007/s00405-025-09553-z
21. Camacho M, Zaghi S, Certal V, et al. Nasal dilators (internal and external) for obstructive sleep apnea: A systematic review and meta-analysis. Sleep Breath. 2016;20(2):597-602. (duplicate of #5)
22. Hopkins C. Re: Correlation between subjective and objective evaluation of the nasal airway. Clin Otolaryngol. 2010;35(2):147-148. doi:10.1111/j.1749-4486.2010.02102.x
23. Erdogan M, Cingi C, Seren E, et al. Evaluation of nasal airway alterations associated with septorhinoplasty by both objective and subjective methods. Eur Arch Otorhinolaryngol. 2013;270(1):99-106.
24. Yağci ZG, Bayar Muluk N, Yazir M, et al. The reasons why individuals who have facial aesthetics constantly want more and more. J Craniofac Surg. 2025; doi:10.1097/SCS.0000000000011610.
25. Xavier R, Azeredo-Lopes S, Menger DJ, Carvalho HC, Spratley J. Comparative functional effect of alternative surgical techniques used in rhinoplasty. Ann Otol Rhinol Laryngol. 2023;132(6):638-647.
26. Rhee JS, Arganbright JM, McMullin BT, Hannley MT. Evidence supporting functional rhinoplasty or nasal valve repair: A 25-year systematic review. Otolaryngol Head Neck Surg. 2008;139(1):10-20.
27. Tomljenović D, Grgurić L, Knežević M, et al. Comparing Nasal Patency Outcomes in Patients Undergoing Septoplasty with Radiofrequency Turbinate Reduction, Turbinectomy, or Valvuloplasty: A Prospective Cohort Study. Medicina (Kaunas). 2025;61(9):1656. Published 2025 Sep 11. doi:10.3390/medicina61091656
28. Wong B, Heppt W, Twu CJ. Cosmetic Rhinoplasty and Nasal Obstruction: What I Look for, How Do I Evaluate the Patient. Facial Plast Surg Clin North Am. 2024;32(4):447-457. doi:10.1016/j.fsc.2024.06.003
29. Xavier R, Shandilya M. Objective Outcome Measures in Nasal Valve Repair and Nasal Obstruction. Otolaryngol Clin North Am. 2025;58(2):215-226. doi:10.1016/j.otc.2024.08.006