Nasal Problems and Treatments

Learn About Your Options for Treating Nasal Symptoms

The nose is a small space and even small imperfections within it can lead to problems. Causes of nasal congestion can be divided into three categories: inflammatory, structural, and functional. Inflammatory causes of nasal congestion include allergies, the common cold, and environmental irritants. The most common source of a structural problem is a deviated septum or enlarged turbinates. Turbinates are normal cylindrical shaped structures in the nose that help warm and process air but easily become enlarged and problematic. Functional problems that can lead to nasal blockage include collapse of the nasal walls or narrowing of critical flow areas within the nose called valves. Additional sources of nasal problems include nasal fracture, polyps, and other masses. Problems originating in the sinuses can also spread into the nose. It is not always obvious at first whether the origin of a problem is the nose or sinuses so a thorough evaluation is critical in getting to the root of the problem.

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How We Diagnose Your Nasal Problems

The first step in diagnosing your nasal problems is having a thorough consultation with you so we can go through a timeline of your symptoms and learn more about your medical history. After that we will conduct a thorough an exam during which we check the nose using a very small scope—about the width of a spaghetti noodle—that is placed in the nostrils to look for swelling, polyps, a deviated septum, enlarged turbinates and other abnormalities. If there is an active infection, we can also check for bacteria with a Q-Tip culture. Since hay fever is often a cause of nasal congestion we commonly test for allergies as well. In addition, sinus problems and nasal problems often occur in conjunction with each other so in some cases we get a CT scan of the sinuses which, like the allergy test, is performed in our office.

Since the sinuses are surrounded by bone, a CT scan, which is taken in our office, provides the clearest, most comprehensive view. We review the scan with you in detail, pointing out which sinuses are swollen and whether there are any structural issues contributing to your particular symptoms.

Treatment Options for Nasal Problems

Non-invasive medical treatment for nasal problems is always the first line approach to treating symptoms and often includes nasal sprays, saline rinses, or, in severe cases, a steroid pill or antibiotic prescription. For chronic sufferers of nasal obstruction who need a more definitive and long lasting solution, we offer both in-office treatments and minimally invasive operating room procedures. Fortunately the turbinates can be reduced in size in the office through one of two methods. The first is called Coblation and it involves administering radiofrequency energy via a small probe thereby shrinking the soft tissue of the turbinates. The second method, called submucosal resection, is a somewhat more enthusiastic method and involves the use of a small shaver to gently reduce the size of the turbinates. Operating room options include straightening the septum, also called a septoplasty, and placement of the Latera implant which is a small support strut placed in the nostril that prevents collapse of the nasal wall.

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