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When a person is recumbent, or is lying down, blood is redistributed from the lower extremities and abdominal cavity (splanchnic circulation) to the lungs. [5] Failure to accommodate this redistribution results in decreased vital capacity and pulmonary compliance , further causing the shortness of breath experienced in PND.
In addition, patulous Eustachian tube generally feels dry with no clogged feeling or sinus pressure. Patients hear their own voice or its echo from inside. [3] [4] They describe it as being amplified and unpleasant. Lying head down may help since it increases venous blood pressure and congestion of the mucosa.
The pressure difference causes the mucosal lining of the sinuses to become swollen and submucosal bleeding follows with further difficulties ventilating the sinus, especially if the orifices are involved. Ultimately fluid or blood will fill the space. In most cases of sinus barotrauma, localized pain to the frontal area is the predominant symptom.
Orthopnea or orthopnoea [1] is shortness of breath (dyspnea) that occurs when lying flat, [2] causing the person to have to sleep propped up in bed or sitting in a chair. It is commonly seen as a late manifestation of heart failure, resulting from fluid redistribution into the central circulation, causing an increase in pulmonary capillary pressure and causing difficulty in breathing.
He further observed and documented that the turbinates in the dependent nasal fossa fill when the patient is lying down. The nasal cycle is an alternation in both time and between left and right sides, with the total resistance in the nose remaining constant. The asymmetric airflow may have some benefit to overall olfactory sensitivity. [6]
Nasal obstruction characterized by insufficient airflow through the nose can be a subjective sensation or the result of objective pathology. [10] It is difficult to quantify by subjective complaints or clinical examinations alone, hence both clinicians and researchers depend both on concurrent subjective assessment and on objective measurement of the nasal airway.
When the maxillary sinus is involved, the inferior oblique muscle may be damaged. [1] The cause of silent sinus syndrome is not well understood. Bacteria in the maxillary sinus may be involved. The connection to the nose may be blocked. [1] [2] This can create negative pressure in the sinus, as secretions are reabsorbed. [1]
Functional endoscopic sinus surgery (FESS) is a procedure that is used to treat sinusitis and other conditions that affect the sinuses. Sinusitis is an inflammation of the sinuses that can cause symptoms such as congestion, headaches, and difficulty breathing through the nose.