3.7 Structural pathology
Not all nasal symptoms are due to mucosal pathology and structural abnormality of the nasal septum, pyramid or tip, is one of the most common reasons for nasal obstruction 50 and might be congenital or acquired. In these patients, nasal airway resistance is increased, which can lead to reduced or uncomfortable nasal breathing51. In certain contact sports, nasal trauma is a frequent complication that can potentially lead to structural pathology. This was confirmed by Passali who demonstrated in seventeen boxers a significantly higher nasal resistance, compared to the normal population reference values 52. Other studies that support the importance of structural pathology in exercise are the studies that show a beneficial subjective effect of nasal dilators that decrease the nasal resistance and are discussed below.