Nasal obstruction
A blocked nose can result from several problems occurring alone or together. Common causes include a deviated nasal septum, enlargement of the turbinates, rhinitis and narrowing or weakness of the nasal valve.
Identifying which structures are contributing to the obstruction is important, as treatment depends on the underlying cause.
Common causes of nasal obstruction
Deviated nasal septum
The nasal septum divides the nose into two sides. If it is significantly bent or displaced, it can narrow one or both nasal passages and contribute to persistent difficulty breathing through the nose.
Enlarged turbinates
The turbinates are structures along the side walls inside the nose that help warm and humidify inhaled air. They can become enlarged, particularly with rhinitis or allergy, and reduce the space available for airflow.
Rhinitis
Inflammation of the lining of the nose can cause congestion, swelling, sneezing and nasal discharge. Rhinitis may be allergic or non-allergic and can coexist with structural narrowing.
Nasal valve narrowing or collapse
The nasal valve is one of the narrowest parts of the nasal airway. Narrowing or weakness of the side wall of the nose can restrict airflow, particularly during deeper inspiration or exercise.
Other causes
Nasal polyps, chronic sinus inflammation, previous injury or surgery and, less commonly, other conditions within the nose can also cause obstruction.
How is nasal obstruction assessed?
Assessment begins with understanding when the obstruction occurs, whether it affects one or both sides of the nose, and whether symptoms vary with sleep, exercise, season or position. Previous nasal injury, surgery, allergy and response to nasal medications may also be relevant.
Examination looks at the nasal septum, turbinates and the space available for airflow. The external structure of the nose and the nasal valve may also be assessed, particularly when narrowing or movement of the side wall appears to contribute to obstruction.
Nasal endoscopy may be used to examine areas further inside the nose that cannot be adequately seen from the front. CT imaging can be useful when sinus disease or another deeper nasal problem is suspected, but is not required for every patient with a blocked nose.
How is nasal obstruction treated?
Treatment depends on the cause of the obstruction. When inflammation or rhinitis is contributing, treatment may include saline irrigation, nasal medications and management of allergy or other triggers.
When significant structural narrowing is present and symptoms remain troublesome despite appropriate medical treatment, surgery may be considered.
Septal surgery
Septoplasty aims to improve the nasal airway by correcting areas of the septum that significantly narrow the nasal passages.
Turbinate surgery
When enlarged turbinates continue to contribute to obstruction despite appropriate medical treatment, procedures to reduce their size may be considered while aiming to preserve their normal function.
Functional nasal surgery
In some patients, obstruction involves the nasal valve or the structural support of the outer nose rather than the septum alone. Functional nasal surgery may involve supporting or reconstructing these areas to improve the nasal airway.
Where the external structure of the nose contributes to both breathing difficulty and concerns about nasal shape, functional and aesthetic considerations can be assessed together.
Nasal obstruction at Hawthorn ENT
Dr Philip Michael has a particular interest in rhinology, nasal obstruction and functional nasal surgery. His assessment considers both inflammatory and structural causes of nasal obstruction, including the septum, turbinates, nasal valve and external support of the nose.
Treatment is tailored to the structures contributing to the obstruction and may involve medical treatment, surgery or a combination of approaches.
Appointments for nasal obstruction
f persistent nasal blockage is affecting your breathing, sleep or daily activities, a specialist assessment can help identify the factors contributing to the obstruction and the appropriate treatment options.