Nasal Obstruction - What Causes It?

Hello!

I am Dr. Sanjay Bhatia, ENT specialist and neuro-otologist. Today we are going to speak on nasal obstruction; the common cause what I see in my clinical practice. If we start, nasal obstruction most commonly seen in paediatric age group is nose block, mouth breathing and nasal discharge. These are predominantly seen with a small adenoid growth at the end of the nose. Deviated nasal septum, hypertrophic reactive turbinates or allergic colds are treated with medications. Adenoids usually do subside with medication but persistent and recurrent episodes of adenoiditis will require surgical management. As the age progresses, around teenage, adolescent ages we see buckling of the nasal septum called deviated nasal septum causing nasal obstruction. The correct age would be around 15, 16 to 18 years if there is a persistent nasal obstruction causing difficulty in breathing, mouth breathing, snoring.

So, the surgery for that is septum correction called septoplasty which can be done in a conventional way or an endoscopic septoplasty. As we go further, we have this constant environmental agent which causes sneezing, watery nose and persistent nasal discharge which chokes the nose causing nasal blockages. These are known as allergic rhinitis which can also have a resulting in nasal obstructions and frequent episodes of allergic rhinitis can lead to soreness of nasal lining leading to nasal polyposis. The early treatment is medication, nasal sprays and anti-allergic tablets. If the symptoms persist and there are nasal polyps which are not regressing in spite of good medications and systemic steroids one has to undergo sinus surgery to remove the nasal polyposis. Another factor for nasal obstructions can be recurrent rhino-sinusitis, bacterial infections and masses in the nostrils.

So this can be tumors, can be in adolescent ages in males we see is vascular masses called as angiofibromas, there can be other tumor factors in the nose which has to be addressed according to the lesion. How effective are the nasal surgeries for the above symptoms? This is a common question asked and discussed with my patients. Now depending on the etiology, the recurrence rates are known. If it is allergic symptoms, we do not control the allergies by surgery. Allergies are controlled by medications only. How severe is the response of your lining to the allergy will show us the recurrences of the symptoms? That's why most of the consultants will tell you nasal polyposis is just to clear the nostrils from the polyps, create a wide surface area for the medications to reach.

Regarding the removal of adenoids, there are various techniques today. Apart from the conventional curate technique, we have nasal endoscopic technique where it is visualized under the vision and shaver system and coblation is used to remove adenoids and the division. So it is no longer applying procedure so the success rate of removal of adenoids is much higher and better. Septoplasty we have already discussed. Sinus surgery for bacterial infections and infective causes is how well we open up the affected sinuses. You create a larger area of drainage and a good antibiotic serves the purposes. Regarding the tumor and other masses, it depends on the etiology and pathology of the tumor, how bad or good the disease is for the recurrence kind of thing. Thank you and you can go through the post and other things on the lybrate website.

Thank you.