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Nasal Obstruction

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Nasal Obstruction

The nose is our preferred way of breathing. Air is warmed, humidified and filtered as it passes through our nose, making it four times more easily absorbed into our lungs, as compared to breathing through our mouth. When your nose becomes blocked, symptoms can be obvious if they happen suddenly, like when you get a cold or have an allergic reaction. But for most people it happens slowly, over time. They become so used to it they think it is normal to mouth breathe. This is often evident in children, when parents say they try to get them to close their mouth and breathe but they won’t. It is really because they can’t.

Nasal Obstruction Symptoms:

Long term nasal blockage can result in early fatigue, snoring and sleep apnea, low exercise tolerance, chronic sinus infections, poor sense of taste, and dental crowding and a high palate from mouth breathing.

Nasal Obstruction Causes and Treatments:

The most common causes of nasal blockage are:

Deviated Septum 

The septum is the vertical structure that divides the nasal passages within the nose into two sides. When the septum is crooked or bent, it is called a deviated septum. Imagine the septum as a piece of tinfoil that has become crinkled. Those bends take up space in the nasal cavities, which can make one or both nasal passages smaller and block the flow of air through the nose.

Treatment: Medications and treatment to reduce swelling of the nasal lining can be helpful. In serious cases, surgery (septoplasty) is need to correct the deviation.

Enlarged Turbinates

The turbinates are structures located on the nasal sidewalls that are made of eggshell thin bone covered in a mucosal lining. Their function is to increase the surface area of the nose to help humidify and filter air. Enlargement of the turbinates results in difficulty breathing through the nose.

Treatment: Medications and treatment to reduce swelling of the mucosal lining can be helpful. Surgery may be necessary to shrink these turbinates if they take up too much room or become fibrotic and scarred. There are several surgical techniques to reduce the size of the turbinates, ranging from simply moving the bones to the side walls to removing part of the turbinates.  This can be done alone or in conjunction with a septoplasty.

Sinusitis 

Sinusitis is an infection of the sinus membranes causing congestion, facial pressure, headaches, yellow or green nasal discharge, and exhaustion. Nearly every sinus infection starts with a viral infection. Under the right conditions, the invasion of the virus into the normal population of microorganisms living in the sinuses (bacteria, yeast, etc) can cause one population to overgrow the others. A viral infection (or cold) can be differentiated from a sinus infection (which is bacterial) by time.  A virus clears in 5-7 days. A bacterial infection lasts much longer, sometimes even months.

If you have repeated bouts of sinus infections and take several courses of antibiotics, the healthy bacteria in your gut and sinuses are also killed. This allows the normal population of yeast in your body to grow, leading to more sinus inflammation and repeated sinus infections, ironically making you more and more sick each time you take antibiotics. Yeast overgrowth can lead to allergic fungal sinusitis, which is a serious condition requiring sinus surgery and chronic steroid treatments.

Treatment: Many over-the-counter medications help treat colds or early sinus infections by drying up secretions and decreasing mucosal swelling. This makes the lining inhospitable to the overgrowth of bacteria so the infection can be controlled early on. For more severe cases, prescription medications such as antibiotics and steroids may be required to help open up the nasal passages.

If you are suffering from chronic sinusitis, detoxification through cleanses and herbal supplements to improve your immune function and clear yeast are very effective. Each course of antibiotics requires at least two months of probiotic use. If all else fails, surgery may be an option to clear anatomic blockage and remove inflamed nasal and sinus tissue.

Allergic Rhinitis

Often called hay fever, is a condition that affects 40 to 60 million Americans. Dr. Dahl utilizes different modalities to treat each patients unique profile. Read more.

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Linda D. Dahl, MD