Blocked Noses
Dr Jason Roth (MED0001185485) — Specialist Otolaryngologist & Head and Neck Surgeon, specialist registration in Otorhinolaryngology, Head & Neck Surgery.
Nasal obstruction — difficulty breathing through the nose — is one of the most common reasons patients are referred to an ENT specialist. There are many possible causes, and careful assessment is necessary to identify all contributing factors and plan appropriate treatment. Treating only one cause while leaving others unaddressed will often result in incomplete improvement.
Why Is My Nose Blocked?
Nasal obstruction can result from conditions that cause swelling of the nasal lining, conditions that cause a structural or mechanical obstruction to airflow, or — most commonly — a combination of both. Common causes include:
Allergic rhinitis (hayfever)
Causes generalised swelling of the nasal lining, present seasonally or year-round. Allergy also progressively stimulates turbinate hypertrophy — the inferior turbinates enlarge over time in response to repeated allergen exposure, further narrowing the airway.
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Deviated nasal septum
A septum that deviates significantly to one side narrows the nasal passage on that side. It may also cause the opposite turbinate to enlarge into the wider available space.
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Enlarged turbinates
The inferior turbinates can hypertrophy from allergy, chronic irritation, or long-term use of decongestant sprays. Enlarged turbinates are a very common cause of nasal obstruction and often need to be addressed alongside any septal correction.
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Nasal valve collapse
Often overlooked, nasal valve collapse occurs when the supporting structures of the nose collapse inward during inspiration, blocking airflow. Patients may notice relief when pulling the cheek sideways or using nasal strips at night.
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Nasal polyps
Benign inflammatory growths arising from the sinus or nasal lining. Large polyps can significantly obstruct airflow and impair the sense of smell. Often associated with chronic rhinosinusitis.
Chronic sinus disease
Chronic inflammation or infection of the sinuses can cause persistent nasal congestion, post-nasal drip, and impaired drainage.
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Adenoid hypertrophy
Enlarged adenoids at the back of the nose are a common cause of nasal obstruction, particularly in children. Assessment of the adenoids is part of a thorough ENT examination.
Treatment
Treatment is directed at all identified causes of the obstruction. Not all causes require surgery — many are managed effectively with medical treatment alone.
Medical Treatment
- Nasal steroid sprays — for allergy, inflammation, and polyps
- Antihistamine tablets and sprays — for allergic rhinitis
- Saline nasal rinses — for clearing debris and improving mucociliary function
- Antibiotics — where bacterial infection is present
- Avoidance of decongestant sprays — rhinitis medicamentosa (rebound congestion from overuse) is common
- Allergy management and immunotherapy where indicated
Surgical Treatment
- Septoplasty — correction of a deviated nasal septum
- Turbinoplasty — reduction of enlarged inferior turbinates
- FESS — functional endoscopic sinus surgery for sinus disease and polyps
- Rhinoplasty — for nasal valve collapse or structural causes
- Adenoidectomy — for adenoid hypertrophy, particularly in children
A thorough consultation will identify all contributing causes and allow a management plan to be developed. A referral from your GP is recommended before attending.
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Dr Jason Roth | MBBS, FRACS (ORL-HNS) | MED0001185485
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
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