Nasal Obstruction and Sinus Problems

Nasal Obstruction In Children

The commonest causes of nasal obstruction in children are allergy and/or large adenoids. There may be an associated chronic nasal discharge. 

Allergy problems are dealt with by managing the allergy with antihistamines and/or nasal steroid sprays. Enlarged adenoids may require adenoidectomy.

Children may also have similar problems to adults as below, but they are less common.

Nasal Obstruction In Adults

Nasal obstruction in adults maybe due to a variety of factors including;

  • Allergy and inflammation, managed non-surgically in most.
  • Nasal polyps. See FESS
  • Deviated nasal septum, see Septoplasty
  • Enlarged turbinates, see Turbinate reduction
  • Nasal valve collapse, a weakness of the lateral walls of the external nose such that they collapse inwards on inspiration thereby blocking the nose.

Assessment requires a thorough examination and usually CT scans to plan appropriate treatment.

Recurrent Acute Sinusitis

Acute sinusitis may follow on from a normal cold due to failed clearance of mucus from the sinuses with a secondary bacterial infection. Rather than the cold resolving after a few days as normal, it worsens again with increasing facial pain and headache that may go on for some weeks.
People who are prone to frequent episodes often have an anatomical variant that narrows their normal ventilation and drainage pathways. These can generally be seen on CT scans and respond well to surgery.

Chronic Sinusitis

This is a non-resolving low-grade sinus infection that persists for months. Symptoms are usually less severe than in acute sinusitis but are unrelenting. Not infrequently, chronic sinusitis results in or coexists with Nasal Polyps. Surgery is indicated if nonsurgical treatment fails.

Nasal Polyps

Nasal polyps are benign nasal masses that can arise anywhere in the sinuses or nasal cavity. They are frequently multiple and are usually on a stalk. They may occur as a result of allergy, chronic infection or spontaneously. They frequently cause nasal obstruction and often secondary infections.
If treatment of infection and inflammation with medication fails to result in improvement, surgery is often beneficial. Unfortunately nasal polyps are often recurrent.

Allergic Rhino-sinusitis

Allergic nasal symptoms include obstruction, sneezing, watery discharge and itch. Management is generally treatment of the allergy and surgery is not usually indicated. Surgery may have a role if allergy treatments fail and;

  • the allergy results in polyp formation or sinus obstruction with secondary infections.
  • The inferior turbinates become chronically enlarged with persistent nasal obstruction.

Surgery does not cure the underlying allergy but may help with symptom management.

Surgical Treatment