If you regularly have trouble breathing through your nose, the cause may be more than temporary congestion. Nasal obstruction can develop when the structures inside the nose narrow the airway. Common structural causes include a deviated septum, enlarged turbinates, and nasal valve problems. These conditions can contribute to mouth breathing, snoring, sleep disruption, and difficulty breathing during exercise.
For people seeking treatment for nasal obstruction in Los Angeles, Dr. Mani Zadeh evaluates the nasal airway to determine what is causing the problem and whether medical or surgical treatment is appropriate. His practice focuses on nasal and sinus disorders, including conditions that can interfere with nasal breathing.
What Causes Structural Nasal Obstruction?
Structural nasal obstruction occurs when the anatomy of the nasal airway makes it harder for air to pass through. Several structures may contribute to nasal blockage.
Deviated septum
The septum is the wall of bone and cartilage separating the two sides of the nose. When it is significantly deviated, one nasal passage may become narrower, making it harder for air to pass. A significant septal deviation can contribute to nasal obstruction, mouth breathing, snoring or disrupted sleep, and difficulty breathing comfortably through the nose during exercise.
Some people have a deviated septum because of birth or childhood trauma, while others develop one without a specific injury. A deviation does not automatically mean surgery is needed. Surgery for a deviated septum may be considered when the deviation is contributing to significant nasal airway obstruction or other symptoms.
Enlarged turbinates
Turbinates are structures inside the nose that help warm, humidify, and filter the air you breathe. When they become enlarged, they can narrow the nasal passages and contribute to nasal blockage. Allergies, infections, inflammation, environmental irritants, hormonal changes, pregnancy, and anatomical variation can all contribute to turbinate enlargement.
When enlarged turbinates are responsible for chronic nasal obstruction and medical treatment has not provided adequate relief, turbinate reduction for nasal blockage may be considered.
Nasal valve narrowing or collapse
The nasal valve is one of the narrowest areas of the nasal airway. Weakness or narrowing in this area can restrict airflow and may cause the sidewall of the nose to move inward during inhalation.
Nasal valve surgery for breathing problems may involve techniques that reinforce or reposition the cartilage supporting the nasal airway. The appropriate approach depends on the anatomy involved.
Also Read: Chronic Nasal Obstruction: When Should I See a Doctor?
When Does Nasal Obstruction Require Surgery?
Not every case of nasal obstruction requires surgery. Nasal blockage can result from allergies, inflammation, sinus disease, nasal polyps, or other conditions that may respond to medical treatment. Surgery is performed when it is considered appropriate for the patient’s condition.
An evaluation may be appropriate when nasal breathing remains difficult despite medical treatment or when symptoms interfere with sleep, exercise, or everyday activities. Symptoms can include:
- Difficulty breathing through one or both sides of the nose
- Chronic mouth breathing
- Snoring or sleep disruption
- Difficulty breathing during exercise
- Ongoing nasal blockage
- Recurrent sinus problems
- Reduced sense of smell
- Nasal congestion that does not improve with appropriate treatment
The presence of a deviated septum alone does not mean that a patient needs septoplasty. The important question is whether the deviation is actually contributing to the patient’s breathing problems. Dr. Zadeh evaluates the nasal airway through clinical examination and may use nasal endoscopy or CT imaging when appropriate based on the suspected cause of obstruction.
How Do You Treat Structural Nasal Obstruction?
The answer depends on what is causing the obstruction. Treatment for structural nasal obstruction may involve septoplasty, turbinate reduction, nasal valve reconstruction, or a combination of procedures when more than one anatomical issue is affecting airflow.
Medical treatment may be appropriate when inflammation, allergies, or another nonstructural condition is contributing to symptoms. When anatomy is the primary reason for the obstruction, a surgical approach may be considered.
The purpose of the evaluation is to identify the source of the blockage before deciding whether surgery to improve nasal breathing is appropriate.
Common Surgical Options for Structural Nasal Obstruction
Septoplasty for nasal obstruction
Septoplasty straightens a deviated nasal septum. Nasal airway obstruction is one of the main indications for septal surgery. The goal is to improve the space available for nasal airflow when septal deviation is contributing to the obstruction.
Septoplasty for nasal obstruction may be performed on its own or along with turbinate reduction when both conditions contribute to restricted airflow.
Turbinate reduction
When enlarged inferior turbinates contribute to nasal airway obstruction, turbinate reduction can decrease their size and create more room for airflow. Several techniques may be used, including radiofrequency treatment, microdebrider-assisted turbinoplasty, submucosal reduction, and outfracture. The appropriate technique depends on the patient’s anatomy, degree of enlargement, and treatment plan.
Turbinate reduction is sometimes performed together with septoplasty when both a deviated septum and enlarged turbinates contribute to obstruction.
Nasal valve procedures
When nasal valve narrowing or collapse contributes to obstruction, treatment may involve techniques that reinforce, reposition, or otherwise improve support of the nasal valve area. The approach depends on the patient’s anatomy and the source of the narrowing.
Also Read: Septoplasty vs. Turbinate Reduction: What’s Causing Your Nasal Blockage?
How a Nasal Specialist Evaluates Breathing Problems
Because several anatomical structures can contribute to nasal obstruction, an evaluation should look at the nasal airway as a whole. A patient may have a deviated septum along with enlarged turbinates, nasal valve weakness, or another condition affecting airflow.
We use nasal endoscopy and, when appropriate, CT imaging to evaluate the nasal passages and sinus anatomy. Nasal endoscopy allows the physician to examine the nasal passages and identify potential causes of obstruction.
This assessment can help distinguish structural problems from obstruction related primarily to allergies, inflammation, nasal polyps, or sinus disease. Treatment can then be directed toward the condition responsible for the patient’s symptoms.
This evaluation can help determine whether surgery is appropriate and which anatomical structures, if any, need to be addressed.
Recovery and Long-Term Results After Structural Nasal Surgery
Recovery depends on the procedure performed and the patient’s individual circumstances.
After septoplasty, swelling and congestion are common during the early healing period. Many patients can return to work or school within about a week, although the nose continues to heal afterward.
Recovery after turbinate reduction varies according to the technique. We have both office-based and operating-room approaches. For radiofrequency treatment, tissue shrinkage occurs gradually over several weeks.
Patients may experience temporary congestion or swelling while the nasal tissues heal. Follow-up visits allow the physician to monitor recovery and address questions or concerns.
Improvement in nasal airflow depends on the underlying structural problem, the procedure performed, healing, and any coexisting nasal or sinus conditions. Surgery is not automatically appropriate for everyone with chronic nasal obstruction.
Also Read: Unlocking Clearer Airways: The Benefits of Turbinate Reduction
Conclusion
Chronic nasal obstruction can have several causes. A deviated septum, enlarged turbinates, and nasal valve problems can all restrict airflow, while allergies, inflammation, polyps, and sinus disease can produce similar symptoms.
When anatomy is responsible for the blockage, medication alone may not address the structural issue. Structural nasal surgery may be considered when an appropriate evaluation shows that surgery is likely to address the cause of the obstruction.
For people experiencing chronic nasal blockage in Los Angeles, Dr. Mani Zadeh can evaluate the nasal airway and discuss whether medical treatment or nasal surgery is appropriate for the underlying condition.
Schedule an evaluation with Dr. Zadeh today!
FAQs
When does nasal obstruction require surgery?
Nasal obstruction may warrant surgical evaluation when a structural problem is contributing to symptoms and appropriate medical treatment has not provided adequate relief. A deviated septum, enlarged turbinates, or nasal valve problems can all contribute to restricted airflow.
What causes structural nasal obstruction?
Common structural causes include a deviated septum, enlarged turbinates, and nasal valve narrowing or collapse. Nasal polyps and sinus conditions can also obstruct the nasal passages.
Can surgery fix chronic nasal blockage?
Surgery can address chronic nasal blockage when a structural problem is responsible for the obstruction. The procedure depends on the cause. Septoplasty addresses a deviated septum, turbinate reduction addresses enlarged turbinates, and nasal valve procedures address narrowing or weakness in the nasal valve area.
What is the difference between septoplasty, turbinate reduction, and nasal valve surgery?
Septoplasty straightens a deviated nasal septum. Turbinate reduction decreases the size of enlarged turbinates. Nasal valve procedures address narrowing or weakness affecting the nasal valve area. More than one procedure may be appropriate when multiple anatomical issues contribute to nasal obstruction.
How do you treat structural nasal obstruction?
Treatment depends on the anatomical cause. Septoplasty may address a deviated septum, turbinate reduction may address enlarged turbinates, and nasal valve procedures may address nasal valve narrowing or weakness. Medical treatment may be appropriate when allergies or inflammation are contributing to the obstruction.
When should I see an ENT for chronic nasal obstruction?
Persistent difficulty breathing through the nose, chronic mouth breathing, sleep disruption, exercise-related nasal breathing difficulty, or blockage that does not improve with appropriate treatment may warrant an ENT evaluation. The evaluation can determine whether the cause is structural, inflammatory, sinus-related, or a combination of factors.