Nasal obstructions are blockages of the nasal cavity that impede airflow in and out of the nose. Either one or both nostrils may be affected. Most nasal obstructions are temporary, caused by colds, allergies, sinus infections, or medications, while others require medical intervention.
Types of Nasal Obstruction
There are several different types of nasal obstruction. These include:
- Deviated nasal septum. The nasal septum is the wall-like structure that divides the left and right nostrils. A deviated septum refers to one that is crooked. This is hardly rare; it is estimated that 80% of people have septal deviations to some degree. Symptoms include difficulty breathing through the nose (especially one nostril) and a runny nose.
- Inferior turbinate hypertrophy. The nasal cavity contains bony structures called turbinates. These are susceptible to irritation from allergies and dust, which cause swelling and breathing difficulties.
- Choanal atresia. This is a congenital defect in which excess tissue in the nasal airway causes a partial or full blockage, resulting in difficulty breathing.
- Nasal polyps.
- Foreign objects in the nose.
- Oversized adenoids.
- Swelling of the nasal lining due to allergies.
Treating Nasal Obstructions
We will carefully examine your nose using a lighted scope and may use a CT scan or MRI in order to diagnose your nasal obstruction. The first step in treating nasal obstructions is getting the symptoms under control. Medications or nasal steroid sprays are often helpful in reducing inflammation of the nose and turbinates and providing immediate, short-term relief. An effective long-term solution may require surgery particularly if the issue involves a deviated septum, turbinates or nasal polyps. Newer surgical techniques include shrinking the turbinates by using radiofrequency energy or a small tissue-shaving device.
Nasal polyps are benign growths that occur on the mucosal lining of the nasal passages. They are typically small and though noncancerous can still cause obstructions of the sinuses, leading to congestion, breathing problems and sinus infections.
Signs & Symptoms of Nasal Polyps
Some nasal polyps are tiny and cause few problems. Others produce symptoms such as runny nose, congestion, sneezing, loss of smell and taste, postnasal drip, headache, sinus pain and pressure and snoring. If symptoms persist longer than ten days and are not associated with a cold or allergies, seek medical attention. Even though nasal polyps are benign, if left untreated they can grow large enough to cause serious complications including obstructive sleep apnea, meningitis, blood clots and aneurysms.
What Causes Nasal Polyps?
Some people develop nasal polyps randomly, but most often there is some sort of triggering mechanism. Common triggers include asthma, hay fever, chronic sinus infections, cystic fibrosis and sensitivity to aspirin and other NSAIDs. Genetics may also play a role.
A diagnosis is usually made through visual inspection with an otoscope or nasal endoscopy. An imaging test, either a CT scan or MRI, can be useful in determining the size of the polyp and in ruling out more serious growths, such as tumors. Allergy tests may be administered in order to identify the substance responsible for your symptoms.
Treatment for Nasal Polyps
Nasal polyps can be treated with either medication or surgery. The goal is to reduce the size of the polyp or remove it completely in order to alleviate your symptoms. Nasal sprays, oral or injectable steroids, antihistamines and antibiotics are all common drug treatments. If they are ineffective, surgery may be performed. The type of procedure depends on the size of the polyp. An outpatient procedure called a polypectomy uses a suction device or microdebrider to remove the lesion and surrounding tissue, and is effective for treating smaller polyps. Larger ones may require endoscopic sinus surgery. In this procedure, a camera is mounted on a flexible tube, and tools on the end are used for excising the polyp.
When the bone and cartilage dividing your nasal cavity is off center or crooked, the condition is referred to as a deviated septum. If the deviation is serious enough, it can cause breathing difficulties and chronic sinus conditions that require treatment.
Most often, a deviated septum is a condition that occurs during birth or fetal development. In other cases, trauma or injury to the nose causes the displacement. This is frequently the result of a sports injury or automobile accident. Occasionally, cartilage in the nasal tip deteriorates as we age, producing a deviated septum.
The perfect nasal septum divides the left and right nostrils evenly, but this is pretty rare; it’s estimated that about 80% of the population has a septum that is off center to some extent. Usually the deviation is slight and goes unnoticed; only the worst cases produce symptoms that affect breathing. Symptoms include nasal congestion (often limited to one side of the nose), frequent nosebleeds and sinus infections, facial pain and pressure, headaches, postnasal drip, and noisy breathing or snoring during sleep.
If the deviated septum isn’t too severe, symptoms may respond to treatment with medications. Antihistamines, decongestants and nasal steroid sprays can reduce congestion and inflammation in some patients. When medicines are ineffective, a surgical procedure known as a septoplasty may be necessary to reposition a crooked septum and improve breathing. This involves removing excess bone or cartilage in order to create a larger breathing space, and is typically performed in an outpatient setting using local or general anesthesia. A rhinoplasty – surgery to reshape the nose – is often performed at the same time.
In order to prevent a deviated septum, protect your nose from injury whenever possible. Wear a helmet or facial protection when playing sports and never ride in a motor vehicle without wearing a seatbelt.
Call Eastern Shore ENT & Allergy at (410) 742-1567 for more information or to schedule an appointment.