Dr David Lowinger MBBS FRACS Ear Nose & Throat Specialist Surgeon
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Adults

Blocked Nose

Blocked nose, also referred to as stuffy nose or nasal congestion which is one of the most commonly occurring problem. Nasal congestion occurs when the tissues lining the nose is swollen which is because of the inflamed blood vessels. If nasal congestion is not treated it can lead to hearing and speech problems. It may also lead to a condition known as sleep apnoea (causes one or more pause while breathing).

Causes

The four main causes of blocked nose are:

  • Infections: Common cold, flu, and sinus infection are all caused by virus infection. These viruses are transmitted by air which causes the nasal tissues to swell up. If the nasal mucous turns yellow or green, it means that bacterial infection has also occurred. Sinus infection also causes nasal congestion which leads to thick discharge of mucous. Sinusitis is the inflammation of sinuses in and around the nasal region causing blocked nose
  • Structural abnormalities: These include deformities of the nose and nasal septum such as deviated nasal septum (cartilage that divides the two nostrils), large inferior turbinates, polyps in the nose, external valve collapse, bent or twisted nose, and large adenoids. These deformities results from an injury or may be present the time of birth. One of the most common causes of nasal congestion is enlarged adenoid glands (tonsil-like tissue situated at the back of the nose). The other cause is polyps (fleshy growths) or tumors in nose that occur due to infection of the nasal sinuses

  • Allergies: Allergy occurs due to the inflammatory response to harmless environmental substances known as allergens such as pollen, dust mites, house dust, and animal dander, tobacco smoke. These allergens releases a substance called as histamine can cause congestion and excess production of watery nasal mucous

  • Vasomotor rhinitis: It is a non allergic condition that causes inflammation of the nose and nasal membranes because of abnormal nerve control of the blood vessels in the nose. Membranes of the nose have the ability to expand and contract. During the allergic response these membranes expand leading to nasal congestion. Some of the factors that expand these membranes are irritants such as perfume, tobacco smoke, and psychological stress

Diagnosis

Your doctor will diagnose nasal congestion by examining the nose and by performing diagnostic tests like allergic skin tests (to check if you are allergic to any allergens), blood test, sputum culture test (to check for bacterial or viral infection), and X-ray of the sinus and chest.

Treatment

Some of the medical treatments to treat nasal congestion are as follows:

  • Decongestants nasal sprays and drops are prescribed to relieve the stuffy nose. These medicines shrink the swollen blood vessels in the lining of the nose. It should not be used for more than 3 days as it may make the congestion worse

  • Antihistamines are prescribed to prevent allergic response and improve the congestion.

  • Adhesive nasal strips are available which can be placed over the nose. These will help in widening the nostrils and makes breathing easy

  • Antibiotics in addition to anti-inflammatory drugs are prescribed for sinus infection that causes pain and swelling around the nose

Surgery may be needed to correct the anatomic abnormalities. Some of the surgical procedures include

  • Septoplasty - To correct the deviated nasal septum

  • Turbinoplasty - For large inferior turbinates

  • Polypectomy - To remove the nasal polyps

  • Functional rhinoplasty - For external valve collapse. Rhinoplasty surgery is done for bent or twisted nose

  • Adenoidectomy - To remove enlarged adenoids

  • Functional endoscopic sinus surgery - To fix the narrow sinus openings

Prevention

  • Avoid smoking which will aggravate allergy
  • Remove the furry pet which causes allergy
  • Increase the humidity in air by using vaporizing or humidifier
  • Drink plenty of fluids, especially hot tea and chicken soup may be helpful
  • Use gentle saline nasal sprays
  • Keep your head elevated when lying down
  • Avoid spraying perfumes
  • Steam bath is advised which helps to open the blocked mucous in the nose
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Royal Australasian College of Surgeons The Australian Society Of Otolaryngology Head And Neck Surgery Australian New Zealand Society of Paediatric Otorhinolaryngology (ANZSPO) The University of New South Wales The University of Sydney Harvard Medical School

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