Nasal Obstruction

What is nasal obstruction?

Nasal obstruction is a common symptom that involves feeling as if there’s not enough air flowing through your nose. It happens when a condition or injury causes a complete or partial blockage in your nasal airway.

When you inhale, air enters your nostrils. It flows through your nasal and sinus passages before making its way through the rest of your respiratory system. But with nasal obstruction, something restricts the airflow. This can make breathing more difficult.

Most people describe nasal obstruction as a feeling of congestion or fullness in their nose. Symptoms that may accompany a nasal obstruction include:

• Pain or pressure in your face
• Changes to your sense of smell (dysosmia)
• Runny nose
• Mouth breathing
• Snoring

All your symptoms provide clues your healthcare provider can use to diagnose your condition and offer treatments that make breathing easier.

What are the most common causes of nasal obstruction?

Causes of nasal obstruction range from temporary inflammation that blocks your nasal cavities or sinuses to structural irregularities you’re born with.

Causes of nasal obstruction include:

• Enlarged adenoids. Adenoids are the glands behind your nasal cavity. When they’re enlarged, they can narrow your airway and make it harder to breathe. Enlarged adenoids are the most common cause of nasal obstruction in children. It’s uncommon in adults.
• Inflammation in your nose or sinuses. Infections and can lead to inflamed tissue that restricts airflow. Conditions include allergic rhinitis, vasomotor rhinitis, sinusitis and nasal vestibulitis.
• Deviated septum. The cartilage and bone that divide your nasal cavity into two passages is called your septum. When it’s crooked or off-center, air can’t pass through as easily.
• Nasal polyps. These noncancerous growths form in the membrane (mucosa) lining your nose and sinuses, blocking airflow.
• Nasal valve collapse. Your nasal valve is the narrowest section of your nasal airway. If it collapses, you may have trouble breathing. People with a deviated septum are at increased risk.
• Choanal atresia. With this condition, babies are born with excess tissue in one or both nasal passages that restricts airflow.
• Tumors. Benign (noncancerous) and cancerous tumors can obstruct your nasal airway. Nasal cancers are extremely rare.
• Injuries to your nose. An injury, like a broken nose, can change its structure in ways that restrict airflow. Falls, car accidents and injuries during contact sports all increase your risk.
• Nasal foreign objects. While adults know better, curious children sometimes create an obstruction by sticking objects up their noses.

How is this symptom treated?

Otolaryngologists (ear, nose and throat specialists) treat nasal obstructions by addressing the condition causing it. They can also recommend or prescribe medications that can ease your symptoms.

Common treatments include:

• Antibiotics. You may need to take antibiotics to kill bacteria causing a nasal or sinus infection.
• Antihistamines. You may need antihistamines if an allergy is causing your rhinitis. Most come in pill form, but some are available as nasal sprays.
• Decongestants. Nasal decongestants can relieve congestion related to allergies or sinusitis. You usually only take this medicine for a few days to relieve congestion.
• Steroids. Steroids can ease inflammation that’s causing a blockage. They come in pill form and as nasal sprays.
• Breathing strips or nasal dilators. Sticking breathing strips on the outside of your nose widens your nostrils so you can breathe better. Nasal dilators widen your nostrils from inside your nose.
• OTC/Home remedies: Several home remedies can help manage a nasal obstruction related to an infection or allergies. If your child has a small, hard object (like a bead) stuck in their nose, methods like a mother’s kiss may help.
• Surgery. Your healthcare provider may need to remove growths or correct structural issues causing nasal obstruction. Surgery is usually a last resort if other treatments haven’t helped.

Surgery for nasal obstructions

Most surgeries that fix conditions related to nasal obstruction are minimally invasive. Often, ENTs use instruments that allow them to operate inside your nose without making physical cuts on your face.

The specific procedure depends on what’s causing the obstruction. Examples include:

• Adenoidectomy to remove your child’s adenoids.
• Balloon sinuplasty to unblock clogged sinus passages.
• Septoplasty to straighten a deviated septum.
• Polypectomy to remove nasal polyps.
• Turbinate reduction to decrease the size of your turbinates (bony structures inside your nose).
• Functional endoscopic sinus surgery (FESS) to remove polyps, diseased tissue, tumors, damaged bone and anything else blocking your sinus passages.
• Extended sinus surgeries to remove tumors using surgery that requires physical cuts (may be needed in addition to FESS, but this is rare).

What are the possible complications of not treating a nasal obstruction?

A nasal obstruction that doesn’t go away can keep you from getting a good night’s rest. In some cases, it can lead to sleep apnea. In children, it can lead to prolonged mouth breathing. This can cause your child’s teeth to develop out of alignment (malocclusion).

Although it’s unusual for cancerous tumors to cause nasal obstruction, it can happen. Without treatment, the cancer can spread. But treating it in the early stages usually cures it.

Can this symptom be prevented?

You can’t always prevent nasal obstruction, but you can reduce your risk. For example, you can take steps to prevent colds, like washing your hands frequently. You can try to avoid things in your environment (like mold or pet dander) that trigger your allergies.

When should nasal obstruction be treated by a healthcare provider?

Some conditions that cause a nasal obstruction clear up on their own. But if you (or your child) experience an obstruction that doesn’t get better within a week, it’s time to schedule an appointment.

Contact your healthcare provider immediately if you have a nasal obstruction and notice red flags of a serious condition, like cancer. Signs include:

• Bulging eyes or double vision
• Facial numbness, swelling or severe pain
• Asymmetrical face or an obvious mass
• Pain in your ears or teeth
• Recurring nosebleeds
• Changes in your mental state
• Fever that lasts for more than a few days