It is a common and often puzzling experience to find that breathing through the nose becomes easier when gently pulling the cheek away from the face. This simple maneuver offers temporary relief from nasal congestion. This indicates a potential underlying structural issue affecting nasal airflow. Understanding nasal breathing mechanics and common impairments clarifies why this action helps.
Understanding Nasal Airflow
The nose is the initial point of contact for external air entering the body. Air flows through the nostrils into the nasal cavity, which is divided by the nasal septum. Inside, structures called turbinates increase the surface area, helping to filter, warm, and humidify incoming air before it reaches the lungs.
A particularly narrow area within the nasal passage is the nasal valve, located in the middle to lower part of the nose. This region, encompassing external and internal components, is where most airflow resistance occurs. Proper function of these structures is important for unobstructed breathing, ensuring air is adequately prepared for the respiratory system.
The Mechanics of Cheek Pulling
Pulling the cheek outward directly affects the nasal valve area. This maneuver physically widens the nasal passage, particularly the internal nasal valve, often the narrowest point of the airway. When this area is compromised, the sidewall of the nose may collapse inward during inhalation, restricting airflow.
Pulling the skin next to the nostril outward mechanically stabilizes and opens this collapsible section. This action reduces airflow resistance, allowing more air to pass through the nasal cavity with less effort. While providing immediate relief, this maneuver indicates a potential structural issue within the nasal airway.
Underlying Causes of Airway Narrowing
Several anatomical variations or conditions can lead to narrowing or collapse of the nasal airway. Nasal valve collapse, a common issue, occurs when the cartilage supporting the nasal valve weakens. This can affect the external nasal valve (involving the nostril) or the internal nasal valve (located deeper within the nose).
A deviated septum, where the wall separating the nasal passages is off-center, can impede airflow by making one nostril narrower. This misalignment can also weaken the nasal valve, contributing to collapse.
Enlarged turbinates, bony structures covered by mucous membranes, can obstruct airflow when they swell due to allergies, infections, or irritants. Trauma to the nose or previous nasal surgeries, such as rhinoplasty, may also weaken nasal structures.
When to Consult a Specialist
If difficulty breathing through the nose persists, especially with temporary relief from pulling the cheek, consulting an Ear, Nose, and Throat (ENT) specialist is advisable. Persistent nasal congestion lasting over 10 days, or accompanied by facial pain, headaches, or disturbed sleep, warrants professional evaluation. These symptoms can affect daily life and overall well-being.
During a consultation, the specialist reviews medical history and performs a physical examination of the nasal passages. This may involve an endoscope to visualize the internal structures of the nose. The Cottle maneuver, similar to the cheek-pulling action, is often performed to assess if widening the nasal valve improves breathing, helping to identify the source of obstruction. Imaging tests, such as CT scans, may also assess the nasal and sinus anatomy.
Solutions for Improved Breathing
Options to address nasal airway obstruction range from non-surgical to surgical interventions. Non-surgical methods include external nasal dilators or strips, applied to the nose to gently open nostrils and stabilize the nasal valve. Nasal sprays (corticosteroids or saline solutions) and nasal irrigation can reduce inflammation and clear mucus, particularly when congestion is due to allergies or infections.
If non-surgical treatments do not provide sufficient relief, surgical procedures may correct underlying anatomical issues. Septoplasty straightens a deviated septum, improving airflow through the nasal passages. Turbinate reduction procedures shrink enlarged turbinates, alleviating congestion. For nasal valve collapse, repair or reconstruction techniques can reinforce weakened cartilage, providing long-term stability and improved breathing.