Suffering with a blocked nose!?

There are generally 2 causes for a blocked nose – firstly, a deviation in your nasal septum (partition) or structural problem with the nasal passages and secondly, swelling of the nasal and sinus lining or ‘Rhinosinusitis’. In extreme cases, if the sinus lining becomes extremely swollen it may be visible inside the nose as ‘nasal polyps’ poking down into the nasal cavity. As part of the generalised swelling of the nasal lining itself, 2 scroll shaped nasal structures called inferior turbinates may swell so significantly that they may block the whole inside of the nose. All these issues may, of course, coexist.

In simple terms, Rhinosinusitis may be due to ‘Allergic’ or ‘Non-Allergic’ causes. In cases of an allergic problem, treatment is centred on avoidance of the allergen concerned once it has been diagnosed, as well as antihistamine tablets and steroid nasal sprays. In non-allergic cases (where no obvious allergen is present), cases are in general managed by steroid nasal sprays alone.

In many cases, the above treatment is satisfactory but in a number of cases I see, however, patients continue to be particularly bothered by the feeling of a blocked nose. They often resort to long term use of nasal decongestants such as Otrivine or Vicks Sinex nasal spray – this is not to be encouraged, as not only does it cause ‘rebound’ phenomena where the problem comes back worse that before but it also damages the nasal lining permanently. This is a condition called ‘Rhinitis Medicamentosa’.

Often the main problem causing the blocked nose is persistently enlarged inferior turbinates. I have been performing a new procedure for reducing the size of these turbinates called ‘powered endoscopic turbinoplasty’ whereby the size of the inferior turbinates is carefully and permanently reduced by a specialised shaver under endoscopic guidance. This is all done up the nose under a short General Anaesthetic.

Conventional techniques to achieve this have involved burning or cauterising the turbinates with diathermy or laser, which I have never advocated as these techniques cause a significant amount of dead, charred tissue and scar tissue up the nose and eventually the turbinate tissue grows back in any case. This new technique offers real and permanent advantages and can be combined with other treatments to straighten a deviated nasal partition (septum) and /or remove nasal polyps under the same anaesthetic.

This is just part of the specialised care I am able to offer you as part of The Canterbury Nose Clinic ethos.

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