Presbynasalis

Background

As with all systems in the body, the nose and paranasal sinuses change in time as we age. Some of these changes have been individually studied, but a unified description of current research has not been published since 1996. Since that time, a great deal has changed in our understanding of the aging nose.

Methods

The English language literature was examined using a combination of PubMed and Google Scholar search inquiries. The focus was on articles published since 1996 that described sinonasal changes or disease processes within the advanced-age population.

Results

Publications since 1996 were prioritized for discussion. Of the 50 articles selected, manuscripts were grouped into categories of allergy and cellular-level change, rhinorrhea, mechanical and airflow change, olfactory change, and sinusitis.

Conclusion

Understanding the normal aging process is essential for otolaryngologists for patient education. We propose use of the term presbynasalis for description of the aging nose, paranasal sinuses, and olfactory system. Several points are consistent across the literature. The immune system becomes less responsive with age, a process known as immunosenescence. The incidence of rhinorrhea increases as the population ages. Though nasal volumes increase with age, other age-related changes may result in the perception of increasing nasal obstruction with age. There is a trend toward diminished olfaction in the elderly, and in some patients, this may be an early manifestation of neurodegenerative conditions. Sinusitis treatment should be similar in the elderly population, and the data demonstrates the safety of surgery when needed.

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