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Nasal Obstruction

Nasal Obstruction

Nasal Obstruction

Nasal obstruction is a symptom rather than a stand-alone diagnosis, and there is a wide range of medical and structural problems that can affect your ability to breathe properly. Structural problems caused by deformities of the cartilage or bony structures of the nasal framework are common causes of nasal obstruction. These include a deviated nasal septum, nasal polyps, large adenoids, as well as swollen turbinate tissue, and nasal valve collapse. Other causes may be non-anatomical and due to conditions that cause the nasal lining to swell, including chronic sinusitis or severe nasal allergies. Each of these nasal obstructions can often be corrected using a variety of surgical techniques.

Inferior turbinate hypertrophy

What Are Turbinates?

  1. Along the side walls of the nose, there are three structures whose role is to humidify, heat, and filter the air we breathe through our nose so it can reach our lungs effectively
  2. There are 3 sets of turbinates in your nose, the superior, middle, and inferior turbinates.
  3. The inferior turbinates are thin bones that are covered by a mucosa lining and made up of vacular soft tissue. They swell and contract based on the amount if blood blow inside them. They can become more swollen based on position (worse lying down to sleep), infections, allergies, or when airflow is uneven (when the septum is deviated).
  4. When the turbinates swell they cause restriction of airflow and lead to increased mucous production.

How is inferior turbinate hypertrophy diagnosed?

  1. Nasal speculum and light examination in the office
  2. Nasal endoscopy – a small camera with a bright light and monitor is used to look inside the nose
  3. A CT scan can demonstrate enlarged turbinate as well, but these scans are mainly looking for evidence of sinusitis.

How is inferior turbinate hypertrophy treated?

  1. Medical treatment involves nasal sprays that help reduce the size of the turbinates such as nasal steroids or nasal antihistamines.
  2. In- Office Procedures can be used to help shrink the turbinates such as coblation or radiofrequency ablation.
  3. Surgical Procedures such as microdebrider (partial removal of bone and soft tissue) or partial resection can be used for more dramatic and long lasting improvement.

Nasal Valve Collapse

What is nasal valve collapse

  1. Sometimes people can have nasal congestion and not have a deviated septum. These patients often “sniff” in deeply to try to get more airflow. This can often cause snoring and mouth breathing, and worsens with vigorous physical activity when breathing is more labored.
  2. The nasal valve is the region of the nose with the highest nasal airway resistance. This part of the nose causes blockage with even small changes.

How is nasal valve collapse diagnosed?

  1. At home, you can do a Cottle Maneuver to learn if you breathing is related to nasal valve collapse
  2. Place the tips of you index and middle finger on your cheeks just to the side of your nose. Press and pull gently to open the nasal valve. If this helps your breathe significantly better than the site of obstruction is likely the nasal valve.


How is nasal valve collapse treated?

  1. Non-surgical methods to help nasal valve collapse include mechanical dilation provided by nasal stips or nasal dilators.
  2. Minimally invasive methods such as nasal valve implants that can be placed under the skin
  3. Surgical methods such as nasal valve repair that is done via rhinoplasty.