Introduction
Having a blocked nose can be very frustrating. A lot of patients put up with having a blocked nose for many years prior to having anything done about it. In most cases you don’t need to put up with a blocked nose and the cause of the problem can be rectified either with medication or alternatively with an operation.
Causes
There are multiple causes of a blocked nose but the commonest ones are as follows:
- Deviated Septum – The septum is the cartilage in the middle of the nose. This may be bent either from the way your body has grown or alternatively from a fracture. The bend in the septum can cause a blockage on one side more than the other.
- Large inferior turbinates – The inferior turbinates are 2 scrolls of tissue which sit on each side of the nose. These scrolls of tissue serve a very important purpose in the form of sensation of nasal airflow, humidification of air and sweeping material from the front of the nose to the back of the nose amongst other purposes. The inferior turbinates can become enlarged via either allergy, inflammation, how your nose has developed or a combination of these. The turbinates also go through a process which is known as the nasal cycle. This cycle is where one turbinate increases in size whilst the other decreases and then they swap over. This accounts for why people notice that they have a blocked nose on one side which then swaps to the other side.
- Nasal valve collapse – The nasal valve is the area on the side of the nose. From a technical perspective this area can be divided into the internal and external nasal valve. The nasal valve can collapse due to an inherent weakness in the cartilage which holds this area open. Patients who have nasal valve collapse may notice that they are holding their cheek out to stretch out their nasal valve.
- Sinusitis – Sinusitis can cause nasal obstruction via generalized inflammation within the nose. This inflammation can be in the form of nasal polyps or alternatively contribute to swelling of the inferior turbinates. This inflammation can then go on to causes nasal obstruction.
Symptoms
The symptoms of having a blocked nose go beyond just feeling like you can’t breathe through your nose. The symptoms may include some of the following:
- Dry mouth
- Decreased smell
- Problems falling into a deep sleep
- Snoring
- Being unable to sleep on both sides
- Feeling tired when waking up
- Decreased exercise tolerance
Diagnosis
Dr Robinson will take a history from you and talk to you in relation to your symptoms. Following this Dr Robinson performs a thorough examination including assessment of the following:
- Septum
- Size of inferior turbinates
- Presence of sinusitis or polyposis
- Presence of nasal valve collapse
This assessment will be performed with a nasoendoscope to visualise the internal structure of your nasal airway. Following this Dr Robinson will explain to you what is causing your nasal obstruction and what the treatment options going forwards are.
Treatment Options
In general there are multiple different treatment options available for nasal obstruction. The treatment option which Dr Robinson will recommend is individualized but the common treatment options are as follows:
- Nasal sprays – Combination sprays of Saline wash to the nose followed by intra nasal steroids.
- Septoplasty and turbinoplasty – This is an operation which involves straightening the septum and decreasing the inferior turbinates.
- Functional rhinoplasty – This procedure involves removing the bent septum and reconstructing it back in the midline. This is the most powerful method of improving nasal obstruction. Dr Robinson audits his results in functional rhinoplasty each year and he has a very high percentage of improvement in breathing through the nose with this procedure.
