Symptoms

Nasal obstruction is the inability to move air through the nose. For some patients, the blockage is mostly at night and may alternate from side to side. For others, it is continuous throughout the day and primarily single-sided. Nasal blockage can impede exercise tolerance. It can also lead to frequent dry mouth due to mouth breathing. Other associated symptoms may include runny nose, itchy nose and eyes, watery eyes, frequent sneezing, facial pain or pressure, loss of smell, nosebleeds.

Causes

• Allergies:  Can be seasonal or perennial, and are often associated with sneezing, clear drainage from the nose, itchy nose, and itchy eyes.
• Deviated Septum:  The septum is located on the inside of the nose in the midline and divides the right nostril from the left nostril. The septum itself can be deviated, blocking one side of the nose. The deviation may be congenital or a result of nasal trauma.
• Turbinate Enlargement:  Three turbinates exist inside of each nostril, the inferior, middle, and superior turbinates. The inferior turbinates are the most common to be enlarged, but the middle turbinates can also block nasal airflow.
• Nasal Valve Collapse:  Two nasal valves exist, the internal and external nasal valves. During inspiration of air through the nose, both of these valves can collapse blocking airflow.
• Nasal Polyps and Sinusitis:  Nasal polyps are inflammatory tissue in the nose that can block airflow. In addition, chronic sinusitis causes inflammation of the lining and of the nose and can create nasal obstruction.
• Large Adenoid Pad:  The adenoid pad is lymphatic tissue located in the back of the nose. When this is enlarged it can cause nasal blockage.
• Nasal Masses:  Can be benign or cancerous.

Symptoms

Nasal obstruction is the inability to move air through the nose. For some patients, the blockage is mostly at night and may alternate from side to side. For others, it is continuous throughout the day and primarily single-sided. Nasal blockage can impede exercise tolerance. It can also lead to frequent dry mouth due to mouth breathing. Other associated symptoms may include runny nose, itchy nose and eyes, watery eyes, frequent sneezing, facial pain or pressure, loss of smell, nosebleeds.

Causes

• Allergies:  Can be seasonal or perennial, and are often associated with sneezing, clear drainage from the nose, itchy nose, and itchy eyes.
• Deviated Septum:  The septum is located on the inside of the nose in the midline and divides the right nostril from the left nostril. The septum itself can be deviated, blocking one side of the nose. The deviation may be congenital or a result of nasal trauma.
• Turbinate Enlargement:  Three turbinates exist inside of each nostril, the inferior, middle, and superior turbinates. The inferior turbinates are the most common to be enlarged, but the middle turbinates can also block nasal airflow.
• Nasal Valve Collapse:  Two nasal valves exist, the internal and external nasal valves. During inspiration of air through the nose, both of these valves can collapse blocking airflow.
• Nasal Polyps and Sinusitis:  Nasal polyps are inflammatory tissue in the nose that can block airflow. In addition, chronic sinusitis causes inflammation of the lining and of the nose and can create nasal obstruction.
• Large Adenoid Pad:  The adenoid pad is lymphatic tissue located in the back of the nose. When this is enlarged it can cause nasal blockage.
• Nasal Masses:  Can be benign or cancerous.

Diagnosis

Physical Exam

Most anatomic abnormalities are identified on routine physical exam.

Nasal endoscopy

A small camera is placed in the nose in order to evaluate for nasal masses, polyps, signs of infection, deviated septum, and enlarged adenoid pad.

Allergy Testing

Performed in patients with symptoms suggestive of allergies.

Imaging

CT scan, as well as MRI, may be used to evaluate for signs of sinusitis or the extent of a nasal mass if one is identified on exam.