Nasal obstruction is one of the most common complaints seen by general practitioners. It can be caused by mucosal or structural abnormalities.
The nasal septum is a structure in the middle of the nose made of cartilage and bone. If it is crooked, or deviated, it can cause breathing problems and lead to snoring and sleep apnea.
Causes
Everybody who has ever had a nose that is stuffy knows how annoying it can be. But for those who suffer from chronically blocked nasal passages this can become a way of life that impacts their quality of life. It can lead to headaches, a loss of sense of smell, fatigue from not getting enough sleep and can even contribute to serious health conditions like sleep apnea.
The causes of nasal obstruction can be divided into mucosal and structural aetiologies. Most mucosal aetiologies can be effectively managed in the primary care setting with referral to an otolaryngologist where appropriate.
Allergies can cause inflammation of the lining in the nose which creates a blockage. This can be due to common allergies or something more severe such as hay fever or asthma. Other things that can cause nasal obstructions are a deviated septum (where the cartilage that separates the left and right nostrils becomes crooked) or pyriform aperture stenosis (where the opening of the nasal cavity becomes narrower than it should be). These conditions are often present at birth but can also develop after trauma, injury or surgery.
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Enlarged adenoids (also known as enlarged adenotonsils) can also be a cause of nasal obstruction in children. The adenoids are situated at the back of the throat and help to fight infection and bacteria but they can get swollen causing them to be a blockage in the nose. A nasal polyp is a tissue growth in the lining of the nose that can also lead to a blockage.
In rare cases nasal obstruction can be caused by a tumour or cyst or even a foreign body. These can be diagnosed by clinical assessment and investigations such as an MRI or CT scan. It is important to seek medical attention if you think that you may have one of these problems as it can be dangerous and life threatening. Identifying the cause of your nasal obstruction can help you to find relief and improve your quality of life.
Symptoms
If you’ve ever had a bad case of a stuffy nose from the common cold or allergies, you know how frustrating and painful it can be. For some people, these symptoms are temporary and easily resolved by medication or home remedies, but for others nasal obstruction is a chronic problem that significantly affects their quality of life and requires medical treatment.
The most common symptom of nasal obstruction is difficulty breathing through the nose on one side or both. This is usually due to an anatomical deformity or inflammation from sinusitis, enlarged adenoids or nasal polyps. A crooked septum is another common cause of nasal blockage and can be present at birth or result from nasal trauma, facial trauma or injury. The septum is the thin wall of bone and cartilage that separates your nostrils. A crooked septum, also called a deviated septum, means that the cartilage is off-center and reduces the size of one nasal air passage.
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In addition to a swollen or obstructed nasal passage, you may also experience nosebleeds. The lining of the nose can be sensitive to excess pressure and will produce blood to try to relieve this pressure. Over time, this can contribute to a stale or runny nose and can increase the likelihood of recurrent sinus headaches.
Other symptoms include an inability to smell or a dry nose that is difficult to breathe through. A deviated septum, enlarged adenoids or nasal tumors can all produce these symptoms as well as nasal congestion.
Visiting an ENT specialist is the best way to determine what is causing your nasal blockage and how to treat it effectively. Dr. Kuperan will use his specialized knowledge of the nose and sinuses to perform a detailed examination and review your medical history. He will then create a treatment plan to provide relief from your nasal obstruction. This treatment plan will likely involve a surgical procedure like a septoplasty or VIVAER. Both procedures are safe and effective at providing long-lasting relief from your nasal obstruction. The procedure is performed on an outpatient basis and takes less than an hour to perform.
Diagnosis
While nasal obstruction is a common condition, it can be frustrating because it interferes with your breathing. When you are unable to breathe through your nose properly, it impacts both your day-to-day life and sleep quality. Nasal obstruction can also lead to health issues like obstructive sleep apnea and loud, disturbing snoring at night. Fortunately, nasal obstruction can be treated by an experienced otolaryngologist who will provide the best solution for your unique needs.
The first step in diagnosing nasal obstruction is a thorough history and physical exam. Your provider will ask about your symptoms, when they started and if they are constant or intermittent. They will then perform an examination of your nose and the area around it. This will include a flexible fiber optic nasal endoscopy, which allows your provider to visualize the more posterior areas of your nasal cavity without the need for general anesthesia.
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This allows us to identify the cause of your nasal obstruction, which may be anatomical (such as a deviated septum), environmental/irritants (like smoke and pollution) or medical conditions such as allergic rhinitis or sinusitis or medications (like antidepressants or blood pressure medicines). Other causes of nasal obstruction are hormonal changes like pregnancy or going through puberty, medications such as narcotics, drugs used for pain management or high blood pressure, smoking, and other factors.
In addition to a physical exam, your provider may recommend a throat culture or CT scan, an MRI or other diagnostic tests. A throat culture is done by swabbing the back of your throat with a long cotton swab to check for certain bacteria that can trigger nasal congestion. A CT scan is a detailed two-dimensional imaging study that can help to identify nasal and sinus problems including deviated septum, narrow nasal passages, enlarged turbinates, nasal polyps, nasopharyngeal tumors or other abnormalities. A maxillofacial CT scan is an X-ray that shows the bone structure of the face, nasal and sinus passages and can be helpful in the evaluation of nasal obstruction due to sinuses and nasal polyps. This is a non-invasive, computerized imaging technique that can be used in place of an MRI for those who cannot have an MRI performed because of medical reasons.
Treatment
Nasal obstruction can be very uncomfortable and may interfere with normal breathing. Some cases are temporary due to illness such as colds or the flu and can improve on their own, while others may require medical intervention. Symptoms include nasal congestion, sinus pressure, nasal discharge and snoring. If you are suffering from these symptoms, it is important to visit an Ear, Nose and Throat specialist (Otolaryngologist) as soon as possible.
During your appointment, your doctor will take your complete health history and will perform a nasal examination. They will look inside your nose and will use a bright light and sometimes an instrument called a speculum to spread open the nostrils. The doctor may also check farther back in your nose with a flexible tube-shaped scope that has a bright light at the tip called a rhinoscopy.
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If your problem is caused by allergies, your physician will prescribe medications to help ease your symptoms. These medications may be taken orally or in the form of a spray into the nose. If your problem is caused by a deviated septum or enlarged turbinate, surgery may be necessary. During this procedure, the cartilage and bone in the nose will be repositioned into its original straight position. In some patients the surgeon will place a plastic stent in the nose to help the septum stay in its proper position until it heals.
For most people who suffer from nasal obstruction, home remedies and medication offer temporary relief. If your condition persists, we encourage you to schedule an evaluation for our VivAer procedure. The VivAer procedure is an effective and minimally invasive treatment that can provide lasting relief for your nasal obstruction.
Blocked noses can be very uncomfortable, leading to headaches and a diminished quality of life. The inability to breathe through the nose can cause chronic fatigue, affecting your daily activities and sleep. In addition, nasal obstruction can lead to sinus infections, causing you to feel miserable. Contact us today to schedule an evaluation and discover how the VivAer procedure can change your life. We can’t wait to help you breath easier!
