"The nose and the bronchial syndromes"

The nose is the first organ which comes into contact with the external environment. It is bound to possess high levels of physiological and protective reactivity and is hence more prone to disorders than the bhonchi. Its main role is indeed to protect the latter. Thanks to the extraordinary functional reserve of the nose, only a relatively small percentage of patients with chronic rhinitis develop asthma. The several clinical manifestations of the rhino-bronchial syndromes depend on the patient's age and on associated pathogenetic factors. In childhood, repeated adeno-tonsillar infections let muco-purulent secretions drip into the lower airways , especially during night-time. In adults, full-blown development of asthma is generally observed with radiological evidence of paranasal sinuses involvement. Finally the presence of irritative receptors may induce bronchial spasms due to cold air inhalation. Despite the still highly controversial interpretation, the nose may play a central role for the bronchial hyper-reactivity.