The upper and lower airways are still often considered separate. However, it is the case that the two areas, from a medical point of view, can hardly be separated from each other. A term was even coined for this view: “United Airways“. What sounds like an airline is a technical term for the fact that the airways belong together – the upper and lower floors together form a unit. The upper tier are the sinuses of the nose, jaw, forehead, and the ethmoid cells between the eyes. When we talk about the lower respiratory tract, we mean the bronchi, i.e. the fine ramifications in our lungs. “Up” and “down” are connected by the pharynx and trachea – through which the air inhaled through the nose or mouth travels to the chest and lungs, where gas exchange takes place – and from there it flows up and out again. It is precisely in this “transport system” that the typical complaints that someone with post-nasal-drip-syndrome (PNDS) or sinubronchial syndrome suffers arise. But why is that?
How does sinubronchial syndrome come about?
The beginning of such a syndrome is usually uncomplicated acute sinusitis. It can be triggered by viruses or bacteria and in most cases disappears completely after a few days to weeks. Sometimes, however, the infected sinus mucus drains downward through the pharynx. Those affected often complain, for example, about a feeling of mucus in their throat – especially when they lean back or lie down. Then gravity does the rest and the mucus migrates from the front of the nose, where it can simply be blown into a handkerchief, backwards towards the throat and collects there before it flows into the bronchi. This phenomenon creates the sensation of having a foreign body in the throat. It is often also severely swollen mucous membranes and constrictions in the fine passages of the sinuses that make it difficult for the mucus to drain and thus “deflect it”.
Because the often viscous mucus carries a large amount of bacteria or viruses with it, the infection also travels with it – final destination: the lungs. Once there, the lower respiratory tract often becomes infected and acute bronchitis develops. If the mucus is not coughed up properly or if several infections occur in a short time, these symptoms can develop into a chronic cough – in up to two thirds of patients with this persistent cough Coughing is assumed to be the cause of such a syndrome. But what can you do to get relief from sinubronchial syndrome or PNDD?
From cortisone spray to surgery – what helps against post-nasal drip?
To answer this question, we have to take a look at the most common causes of such a syndrome. In some patients, these are anatomical features and changes that, for example, narrow the upper airways or impede the mucous drainage. These include polyps – small protuberances of the mucous membrane that represent an obstacle to unhindered drainage. The situation is similar when the nasal septum is crooked or the turbinates are particularly thick. The result: narrowed ducts that stop the mucus. In such cases, surgical intervention is often useful to straighten or remove the anatomical peculiarities. After a successful surgery, those affected often report that they can breathe better through their nose. At the same time, the fixed mucus can be sucked out under anesthesia – and any thickened mucous membranes removed.
If the anatomy is not the problem, it is often caused by viral infections that have not been properly cured – or allergic reactions that constantly affect the mucous membrane, sometimes permanently, to swell. In these cases, methods have been proven to promote ventilation of the sinuses.
The following measures promote ventilation of the paranasal sinuses:
- Secretolytics intended to loosen mucus
- Antihistamines intended to counteract allergic reactions
- Cough suppressant medication. However, special caution is required here if an underlying bronchial disease such as bronchial asthma is already known
- Decongestant nasal sprays and drops, but only for a limited period of time so that you don’t get used to it
- Cortisone nasal sprays that work directly in the sinus to help fight inflammation
Especially in milder cases, nourishing nasal sprays, for example with the active ingredient dexpanthenol, and regular rinsing of the sinuses with isotonic saline solution are proven to be helpful. These are available over the counter in most pharmacies.
Especially if you have long-lasting symptoms or severe symptoms, you should consult an ear, nose and throat doctor.
I offer the treatment of sinubronchial syndrome or post-nasal drip syndrome and advice on possible therapies in my practice. Feel free to contact me and book now your appointment conveniently online.
- Deutsche Apothekerzeitung, 2008. Vom Husten und Schnupfen zum sinubronchialen Syndrom. Retrieved via https://www.deutsche-apotheker-zeitung.de/daz-az/2008/daz-47-2008/vom-husten-und-schnupfen-zum-sinubronchialen-syndrom on 09/09/2022
- Kroegel, C., & Costabel, U. (Eds.). (2013). Klinische Pneumologie: das Referenzwerk für Klinik und Praxis. Georg Thieme Verlag.
- Gesundpedia.de, 2021. Sinubronchiales Syndrom. Retrieved via https://gesundpedia.de/Sinubronchiales_Syndrom on 09/13/2022