Introduction
Welcome to the first post in our series dedicated to understanding the complexities of snoring and upper airway obstruction. As an otolaryngologist, I am often asked why we snore and what can be done about it. To address these questions comprehensively, we must first explore the anatomy involved. In this series, we will start at the top with our noses, examining the intricate structures and functions of the nasal passages. Understanding these areas is crucial in grasping how they contribute to snoring and airway obstruction, paving the way for effective solutions and treatments. Join me as we embark on this journey through the upper airway, uncovering the key elements that influence our breathing and sleep quality.
This is a review of your external nasal anatomy. This is the inlet for airflow into your body ultimately ending down in your lungs. Let’s start with some simple but fundamental questions:
1. Why Do We Have a Nose?
The nose serves multiple functions. The most important is intake of air to help us breathe. During the intake of air, the nose regulates the temperature and humidity levels of the inspired air. This is most important when we are breathing cold, dry air. This has been found to influence the shape of our nose.
2. How Did Our Nose Obtain Its Shape?
The shape of our nose is a combination of evolutionary changes—including the migration of our face underneath our brain.
Recent studies confirm another factor influencing the shape of our nose was the weather.
Our ancestors living in cold and dry climates benefited from having long and narrower nostrils because this exposes more inspired air to the nasal lining allowing it to be more easily warmed and humidified. The noses of people living in warmer climates do not have all this work to do and became shaped shorter and wider. There are other genetic and cultural factors which have helped shape our nose.
3. How Does the Nose Warm and Humidify the Air We Breathe?
When you breathe in through your nose, the air travels through a pathway lined with tiny hair-like structures called cilia and a moist, warm mucous membrane. Here’s how the nose warms and humidifies the air:
- Warming the Air: Inside your nose, there are lots of tiny blood vessels that produce heat. As the air passes over these vessels, it gets warmed up to nearly body temperature. This is important because it prevents cold air from shocking your lungs and other parts of your respiratory system.
- Humidifying the Air: The mucous membrane lining your nasal passages is always moist. As air flows over this moist surface, it picks up moisture. This added humidity is crucial because it helps keep your airways and lungs from drying out.
By the time the air reaches your lungs, it’s warm, humid, and comfortable for your body to use, making breathing smoother and more efficient.
Now let’s look at the external nasal anatomy which includes the nasal bones and cartilage.
The Nasal Bones are two small paired bones (left and right). Importantly, the nasal bones account for 40-50% of all facial fractures!
The main components of the nasal cartilage are the Upper and Lower Lateral Cartilage. The Upper Lateral Cartilage are two paired cartilage structures connected between the nasal bones and the Lower Lateral Cartilage.
The Lower Lateral Cartilage (also known as the Alar Cartilage) are two paired cartilage structures just below the upper lateral cartilage which join at the midline and form the columella. The nasal columella is the small strip of tissue that separates your two nostrils at the base of your nose. If you touch the bottom part of your nose right between your nostrils, that’s the columella. It’s an important structure because it helps support the shape of your nose and keeps your nostrils properly positioned.
