We have classified nasal obstruction causes into reversible and non-reversible. Unfortunately, over time reversible causes can become non-reversible.

Reversible Causes

Reversible causes are really chronic inflammatory situations. Underlying allergy, infection, or other causes of mucosal thickening represent the majority of problems. Because medical therapies can help, we first try a minimalistic medical approach (usually try a combination of nasal steroids, nasal saline rinses, and decongestants). Allergy testing is always a good idea and may allow us to recommend some simple lifestyle changes that offer improvement. Other patients have tried mechanical devices such as Breathe Right strips, intranasal springs, or nose braces ( www.nosebrace.com or www.sansotec.com). Unfortunately, after a long period of time, the ability to undo the inflammation is reduced, and surgical therapies may become necessary.

Non-Reversible Causes

Non-reversible causes include deformities of the nose and the nasal septum. The nasal septum is the thin, flat cartilage and bone that separates the nostrils and nose into two sides. These deformities are usually due to an injury at some time in one’s life. The injury may have been many years earlier and may even have been in childhood and long since forgotten. Seven percent of newborn babies suffer significant nasal injury just from the birth process, and of course, it is almost impossible to go through life without getting hit on the nose at least once. Therefore, deformities of the nose and the deviated septum should be fairly common problems — and they are.

If these deformities create obstruction to breathing, they can be corrected with nasal airway surgery, also called a “septoplasty and turbinate reduction”. The turbinates are shelf-like structures in the nose designed to warm, filter, and humidify the air. They can often become permanently enlarged, resulting in chronic congestion. Reducing these tissues with a radiofrequency device can be especially helpful. Trying Afrin nasal spray every twelve hours for three days is a useful test to see if surgery will help.