This can be caused by problems with the shape of the cartilage and bone of the nose inside and out. Twists , bends and deviation of the nasal septum and external nose can occur from injury or be part of “ a family nose”! Sometimes the outside of the nose may be twisted or flat as well or the cartilages of the tip of the nose may be weak making them suck in with breathing and sniffing. The blockage is usually worse on one side or may only affect one side. Very rarely blockage on one side may be due to a growth or tumour. Treatments include septoplasty, rhinoplasty and septorhinoplasty.
Nasal blockage with stuffiness and “a permanent cold”
The lining of the nose and sinuses may be oversensitive causing it to swell and run. This is called rhinitis when mainly the nose is involved and non-infective rhinosinusitis when the nose and sinuses are involved. The running may be watery out of the front or thick which goes down the back into the throat as well. This is a post-nasal drip, which may cause a cough and throat clearing. Swelling inside the nose due to rhinitis makes the turbinates too big so that they block the nose. The blockage is often worse lying down and may move from one side to the other. Polyps are produced by swelling of the sinus lining which then hangs down like grapes into the nose to block it. Polyps often cause problems with smell and taste too and can make the head and face feel solid and “full”. Treatments include turbinate reduction, polypectomy, functional endoscopic sinus surgery and balloon sinuplasty.
Nasal blockage with pain and discharge
Pain or pressure in the face and forehead and mucky discharge blown from the nose together with blockage usually means you have sinusitis with infection. This can be on one side following a cold or can be on both sides especially in patients with long-standing problems. Facial or head pain on its own and that comes and goes is very unlikely to be sinusitis. Treatments include functional endoscopic sinus surgery and balloon sinuplasty.
Nasal blockage with sneezing, itching and running
Sometimes the nasal lining can be oversensitive because of allergic rhinitis. Year round allergy is mainly due to house dust mite or cats. Seasonal allergy is most commonly hay fever due to tree and grass pollen. Rhinitis on its own has not be proved to be due food or dairy products.
Nasal injury and fracture
If the shape of the nose may have changed with injury it is best checked about 5 – 7 days later when the swelling is settling and it is easier to judge the look of the nose. Sometimes, even with a broken nose the shape does not change as the bones are cracked but not displaced. However if the nose does look bent or flatter then corrective surgery will be needed. Treatments include manipulation under anaesthesia of nasal fracture, septoplasty, rhinoplasty and septorhinoplasty. If your nose is completely blocked on one or both sides after injury you should see a doctor immediately as you may have had a bleed into your septum which needs urgent treatment called drainage of septal haematoma.
These can often be treated simply with cautery after numbing the inside of the nose with local anaesthetic on cotton-wool. Usually a small blood vessel can be seen on the septum at the front of the nose on the inside.
Nasal crusting and whistling
The nose needs examining with a telescope / endoscope and camera to check for holes in the septum (septal perforation) and nasal lining problems. Some septal perforations can be repaired.
Snoring and obstructive sleep apnoea (OSA)
Snoring is extremely common and may affect as many as 45% of us. Everybody needs undisturbed, restful sleep in order to function well and remain healthy. Most people seek to remedy their snoring problem if it is embarrassing or severely disrupts their own or another’s sleep, resulting in irritability, frustration, tiredness, anxiety & a lack of energy. Sleep apnoea which occurs when the blockage of snoring is so severe that air stops flowing may aggravate high blood pressure and chest and heart problems. The daytime sleepiness of sleep apnoea may also be dangerous particularly when driving. Individual solutions are possible for all patients who snore.
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