Nasal Obstruction

There are several cases of nasal obstruction and rarely this constitutes a phenomenon of all or nothing. Why does a patient with nasal obstruction suddenly decide to seek medical attention? Sometimes the problem becomes significantly worse or the patient becomes more aware of it. Once attention is paid to the obstructive condition, it seems to be getting worse gradually. Patients with acute nasal obstruction due to a nasal trauma immediately become aware of the problema, and are anxious to correct it. The patient may refer to experiment a mouth dryness or respiratory obstruction. The anamnesis is the key to the diagnosis It must be ascertained on which side of the nose the obstruction is present, and if this is constant, or appears and disappears. It is also necessary to identify the factors that cause it and those that relieve it.

The nose must be carefully examined. Unilateral obstruction is constant and involves anatomical bases. It may be a foreign body, a polyp or tumor, usually an obstructive deviation of the nasal septum.

Bilateral obstruction can be caused by polyps, tumors, deviations of the nasal septum or by the falling of the tip of the nose related to the aging process.

Allergic rhinitis also manifests as nasal obstruction, in this case, in general, the problem is bilateral and fluctuating. Many patients report that when they lie down on one side of the nose Is obstructed; It is always the one that remains in the lowest position and, if you change position, the discomfort disappears and the other side is obstructed, this is a normal physiological response and thus the patient should be made aware. No treatment is required.

The nose is a dynamic organ that serves to filter, heat and humidify the inspired air and, to a certain degree, recover the moisture that is lost in the exhalation and preserve some heat.

Due to this intense process, the nose passes through a nasal cycle in which one side becomes congested while the other is congested, the latter performs most of the work, while the congested side has the opportunity to rest. In most individuals, cycles are repeated about four times a day. In some subjects, this normal nasal cycle is exaggerated or at least attracts attention because the patient finds it annoying.

Those who go with the doctor should be evaluated to rule out other problems such as anatomical obstruction or inflammatory disease. A good explanation helps the patient understand what is happening and that there are no problems to look for. Of course, it is the physician’s responsibility to identify the normal nasal cycle and to resist the temptation to resort to surgery or unnecessary medications. Allergic rhinitis can also occur with rhinorrhea in addition to this, the most common symptoms are nasal obstruction, sneezing, lacrimation and rhinorrhea; Are seasonal or perennial.

Allergic rhinitis may be related to sinus disease and may manifest with nasal polyposis. The diagnosis is initially established based on the anamnesis.

On examination it is found that the mucosa covering the turbinates is swollen and often has a blue color. The nasal smear shows eosinophils, basophils, or both. Applying 0.25% phenylephrine to the nose alleviates the obstruction. Examination reveals polyps, and CT of sinuses indicates the magnitude of structures.