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przyssawka t1_j1hezwm wrote

Reply to comment by drgeta84 in What specifically about ginger/menthol/wasabi causes one's sinuses to open? by Bartendiesthrowaway

I'd like to add to this with: subjective feeling of decongestion is related to perception of airflow, and substances OP mentioned provide an additional "cooling effect" by chemically stimulating the cold receptors. This is interpreted as increased airflow - similarly to how after using a cooling spray on your skin it's suddenly way easier to feel even a slight breeze. There was even a study done on that effect, that proved that menthol alone can increase the subjective feeling of decongestion on par with some actual decongestant with zero increase in nasal flow.

Drugs such as xylometazoline and adrenaline delivered topically will actually affect the size of nasal conchae (turbinates) - with mid concha hanging directly over the maxilary sinus entrance.

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everything_in_sync t1_j1ixzqr wrote

Is that why I feel like I can take deeper fresh breathes walking outside on a cold morning after a snowfall?

Would that also mean that the sense5 commercials were accurate and I should skydive during an alaskan winter for optimal freshness?

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przyssawka t1_j1izih5 wrote

yes. For the first question at least. Never skydived in winter.

*Subjective* nasal patency (the perception of airflow) and nasal airflow are two completely different things. The study I posted compares effects of different air conditions on the perception of airflow. Cold air (or rather "heat loss by mucosa") was consistently the best way to evoke the feeling of decongestion. None of the conditions improved the actual flow.

This direpacy between the flow and perception can also cause the adverse effect for patients who underwent concha reduction surgery (conchoplasty) or Endoscopic Sinus Surgery, to suffer from "empty nose syndrome", which is the subjective feeling of low nasal patency with optimal airflow.

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Feminist_Hugh_Hefner t1_j1jduhc wrote

interesting study.

a minor point, "patency" is the "openness" of the airway, without regard to how it is measured. The authors use "subjective nasal patency" to discuss the reported sensation and just say "airflow" when they are talking about flow measured by rhinomanometry

good find and very interesting points in there, including the lack of understanding on where, exactly, cold sensory areas are located, and the question that menthol may have a direct effect on lowering respiratory drive

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Thetakishi t1_j1kc8vc wrote

Thanks for the study. Extremely interesting and partially worrying as I've considered seeing someone about my turbinates, although I have heard about empty nose syndrome before.

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ratherenjoysbass t1_j1k6pao wrote

Well cold air will constrict blood vessels which will reduce swelling a bit so that is part of it

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kbolser t1_j1jf0sr wrote

Not so much the size of the conchae as these as the scrolls of bone, but the venous plexuses that overly them. Epinephrine (adrenaline) and the like cause the smooth muscle in their walls to constrict making that tissue smaller and opening the passages

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przyssawka t1_j1jfngc wrote

Conchae are more than just the scrolls of bone in anatomy. A popular outpatient procedure conchoplasty (also called turbinoplasty) removes (or simply destroys) the mucosal part of conchae usually without touching the bone itself (though "breaking" the conchae is sometime a part of the procedure)

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[deleted] t1_j1jgd9p wrote

[removed]

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przyssawka t1_j1jgskg wrote

The confusion may be due to poorly written wikipedia entry on conchae, which is extremely inconsistent:

>Conchae (/ˈkɒnkiː/), also called a nasal turbinate or turbinal,[1][2] is a long, narrow, curled shelf of bone that protrudes into the breathing passage of the nose

followed immediately by:

>Conchae are composed of pseudostratified columnar, ciliated respiratory epithelium with a thick, vascular, and erectile glandular tissue layer.

I'm a head and neck surgeon and I've never heard anyone in the field make a distinction between the mucosa covering the concha and the bony part, mostly because it's the mucosal part that's important for things like FESS procedure (outside of cases of Concha Bullosa).

It's similar to the labyrinth of the inner ear. Can mean the petrous part alone but it's commonly used to refer to what it contains as well. Anatomically the whole structure is called a concha and that includes the mucosa.

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kbolser t1_j1jhbfk wrote

I need to read up on it more (and I don’t mean Wikipedia). I respect your credentials, but I’m still not convinced from a strictly anatomical perspective

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przyssawka t1_j1jhn7i wrote

What you're claiming may be an actual anatomical distinction, I'm just saying from a professional perspective I have never heard any fellow ENT not include the erectile tissue as part of the "concha"

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NegativelyMagnetic t1_j1k0pm8 wrote

Yup, I'll just add that there's a lot of ways to clear other breathing issues beyond sinuses

Oxymetazoline is a general long-acting decongestant / vasoconstrictor for general sinuses or stuffy nose; fluticasone is a long acting mild glucocorticoid for allergies and mild asthma by opening up the brancioles in the lungs by reducing inflammation, as well puffers like salbutamol and ipratropium for short term asthma attacks and mildly low spo2 levels (+ used secondary for many issues beyond just asthma attacks)

The issue with methanol by itself is that, while it might alleviate the sensation, if your airway is significantly compromised its not going to do anything about low spo2 levels. But it's great for mild sinuses since it provides a bit of immediate relief. It's very often added to other decongestants that takes longer to start working for the same reason. Another alalogy is how people find it easier to breathe in colder air, especially during hot summer days

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DanTacoWizard t1_j1l3bo1 wrote

I see it is a subjective feeling, but my nose is legitimately less stuffy after consuming these substances. How is that so?

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iam666 t1_j1kwyle wrote

What is a cold receptor? What stimuli does it measure, and why would a chemical cause it to misfire?

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przyssawka t1_j1l46ow wrote

>what is a cold receptor?

Aδ and C nerve fibers have a protein that responds to heat dissipation and triggers the “gentle cooling” effect. That protein is TRPM8 and on top of being activated by cold (due to part of the protein changing shape) it can also be activated by menthol and eucalyptol.

More on that here

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iam666 t1_j1l786h wrote

Thanks! It seems obvious in retrospect that protein folding is the mechanism here. Biochem was never my forte.

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