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Nasal Obstruction

Why do I have nasal obstruction?

Nasal obstruction is perhaps the most common symptom evaluated in the Stanford Sinus Center. Many conditions can cause you to experience this, including:

  • Allergic rhinitis with inferior turbinate enlargement or hypertrophy behind the nostrils.
  • Structural problems of the nose, such as a deviated or crooked nasal septum
  • Sinusitis (acute or chronic)
  • Nasal polyps, and other tissue growths within the nose
  • Adenoid hypertrophy (usually in children, but sometimes also found in adults)

How do I get relief of my nasal obstruction?

Medications are typically first used to provide relief. The type of medication depends on what is the cause of your nasal obstruction. Typical over-the-counter medications include the following:

  • Antihistamines, which provide symptom relief for allergic rhinitis. Examples include Claritin, Allegra, Zyrtecand Clarinex.
  • Decongestants, which quickly help to ‘open up’ the nasal passages. Oral examples include Sudafed, while topical sprays include Afrin or Neosynephrine. Topical nasal decongestant sprays are helpful in providing immediate relief if you have a cold/URI, but prolonged use of these sprays after more than 7-14 days can actually result in worsening nasal obstruction due to side effects. Continued use of these sprays that contain oxymetazoline or phenylephrine for a period longer than 5 days should generally be avoided.
  • Steroid sprays, which help to decrease inflammation, are used in the treatment of allergic rhinitis and sinusitis. These sprays need to be prescribed by a physician.

What if none of the medications work in relieving my nasal blockage?

You should seek medical attention to help ascertain the causeof your nasal blockage symptoms. If you have seen a doctor and medications do not help, an office biopsy or perhaps surgery may be indicated, depending on the reason for your nasal obstruction. Surgery can be performed to help relieve nasal obstruction in these conditions:

  • Inferior turbinate hypertrophy
  • Deviated nasal septum
  • Chronic sinusitis
  • Nasal polyps
  • Adenoid hypertrophy in children

What is inferior turbinate hypertrophy?

The nasal cavity has 3 turbinates, or cylindrical shelves of tissue,on each side of the nose – the inferior, middle and superior turbinates. The inferior turbinate is the most prominent shelf and is located just behind the nostril. This structure can sometimes be seen from externally, and if enlarged, can also be mistaken for a nasal polyp. Inferior turbinates can swell up, or hypertrophy, in response to allergies, such as dust and pollen, or infection, or just bad luck unfortunately. In certain chronic cases, the swelling doesn’t disappear even after removal of the trigger, leading to chronic nasal obstruction.

How can surgery help with inferior turbinate hypertrophy?

If medications do not help to relieve to obstruction associated with inferior turbinate hypertrophy, surgery can often be quite helpful. There are many kinds of surgical procedures that can be performed for inferior turbinate hypertrophy, some of which can be performed in the office, and some in the OR. In the Stanford Sinus Center, we perform all of these minimally invasive procedures to remove the swollen tissue from within the bulky inferior turbinates, but leave the overlying skin lining of the turbinates intact. This technique helps to hasten recovery times, and reduces the chance of removing too much inferior turbinate tissue, which can lead to the feeling excessive drying of the nose in some patients.

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