Nasal Obstruction


This is what a normal nasal cavity looks like to an ENT

Nasal obstruction can occur from a number of reasons, some of which are listed here:

  • Deviated Nasal Septum
  • Turbinate Enlargement
  • Nasal Polyps
  • Allergies
  • Sinusitis
  • Variants of Normal Anatomy (Concha Bullosa)
  • Adenoid Hypertrophy
  • External Nasal Valve Collapse


Treating nasal obstruction depends on the cause of it. In this particular case, we will address the deviated septum and turbinate hypertrophy (enlargement). The septum is a fixed structure which is very frequently crooked or deviated to one side or the other. Because it is fixed, it doesn’t move. It causes the same amount of obstruction of breathing at all times. However, most people feel that the amount of obstruction they have varies depending on many things. One cause for this is the turbinates which frequently shrink and enlarge throughout the day. They are dynamic structures.

Medical treatment for nasal obstruction also depends on the cause, but usually begins with a nasal spray in most situations. These sprays are topical steroids which are generally safe to take for long periods of time. There are also topical antihistamine sprays which are very effective for allergic nasal symptoms. Typically, sprays exert the most effect on the turbinates.

Septoplasty refers to straightening the septum so that it does not obstruct breathing. Turbinate reduction refers to shrinking the turbinates so that they are smaller and less obstructive, but the process also helps prevent them from being as dynamic. In other words, they will not cycle through the shrinking and enlarging process nearly as much.
A septum can be straightened by a number of different techniques, but all currently effective techniques require surgery. Likewise, turbinates can be reduced surgically but this can be done either in the office or in the operating room. The office technique is quicker with good initial results that may start to wear off after a few years. The technique in the OR has excellent results which last at least 5 years and often far longer. We do not recommend the removal of turbinates as they serve an important function of warming, humidifying, and filtering the air you breathe. Nevertheless, when they are enlarged, reduction can preserve their normal function but substantially improve breathing.

Both procedures (septoplasty and turbinate reduction) are often performed together and are well tolerated with few major risks. If you suffer from nasal obstruction, please visit our office for a consultation and discussion regarding the medical and surgical options which are available.

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