Any person who has suffered from a nose block (during a cold etc) will appreciate the importance of normal nasal breathing. An obstruction can vary from mild stuffiness to complete blockage. The severity of the symptom ranges from slight and tolerable blockage to high level of discomfort affecting quality of life (sleep, daytime activities and productivity).
The nose is a complex organ which provides a passage for breathing, warms and humidifies the air, allows us to smell and allows drainage of sinus secretions. The nose is divided into two chambers by the nasal septum which is a bony-cartilaginous structure. The side walls are bony with three shelves called turbinates. The paranasal sinuses open into the clefts formed by the turbinates.
Nasal blockage causes decreased sense of smell and taste, mouth breathing, snoring, halitosis and obstructive sleep apnoea and it’s sequences.
l Deviation of the nasal septum is a common cause of nasal block. This can be developmental or secondary to trauma. Though the deviation is to one side block is usually felt on both sides due to compensatory swelling of turbinate on the roomy side. Septal deviation cannot be corrected medically the surgical correction involves a procedure called septoplasty.
l In allergic rhinitis, nasal block is accompanied by running nose, sneezing and eye irritation. If not associated with structural variations a medical management is tried. In case of failure of medication surgical correction of septal deviation and turbinate reduction will alleviate obstructive symptoms.
l Infectious causes: Acute viral or bacterial upper respiratory infections frequently cause nose block due to swelling of lining mucosa and accumulation of secretions in the passage. Chronic sinusitis also causes a stuffy nose.
l Hormonal variations and certain drugs also account for reversible nasal blockage. Indiscriminate use of topical nasal decongestant sprays leads to nasal obstruction called rhinitis medicamentosa.When psychological stress, underactive thyroid gland, pregnancy, alcohol and irritants cause vascular engorgement in the nose leading to blockage it is called vaso-motor rhinitis.
l Nasal masses can be either malignant or benign. Nasal polyps are commonly come across. These are usually associated with allergies and asthma. They can be managed medically and surgically in some cases.
The malignant masses tend to be caused by squamous cell carcinoma of the area. One should also watch out for the structures entering the nasal cavity from areas like the naso-pharynx (area behind the nose), the cranium (above the nose), orbit (eye socket ) and the hard palate below the nose. Other benign lesions seen are inverted papillomas, chondroma, haemangiomas.
Granulomatous conditions like tuberculosis, atrophic rhinitis, rhinoscleroma affect the lining mucosa and frame-work of the nose causing nose block. In atrophic rhinitis though the nasal passage is roomy nose block is experienced since there is no sensation of airflow in the nose.
Hence if nasal obstruction is persistent it is advisable to get a medical evaluation done so that serious condition, if any, are diagnosed at an early stage and appropriate measures can be taken in case of benign conditions to improve the quality of life of the patient. With advances in technology several methods of turbinate reductions like radio frequency assisted turbinoplasty, co-ablation turbinoplasty and micro debrider assisted turbinoplasty are available.
Septoplasty, the surgery for correcting nasal septal deviation can be done conventionally or endoscopically. The procedure does not involve any external facial incision and requires two days of hospitalisation.
To conclude, nose block has many causes-some are medically corrected while others require surgical correction. Hence the condition has to be evaluated by a specialist to ensure appropriate solutions.