There are three major causes for nasal obstruction.
1. Mechanical causes are best treated by surgery and are due to decreased space inside the nose. Mechanical obstruction can be due to narrow nasal passages, nasal valve collapse, a deviated septum or big turbinates.
2. Mucosal swelling due to disease or allergy can also decrease nasal airflow.
3. Finally, altered perception of nasal airflow can be a cause of a sensation of nasal obstruction. These last two causes are best treated medically.
A septoplasty is a procedure that corrects a deviated nasal septum. The septum itself is an anatomic structure dividing the nose into left and right nasal cavities. When the septum is deviated it can interfere with nasal breathing. This causes a person to complain of nasal obstruction, congestion or the inability to breathe through one side of their nose.
A functional septorhinoplasty is a form of nasal surgery performed to improve both the external appearance of the nose, along with the internal breathing capabilities. We call it a ‘functional’ surgery, as the procedure is not carried out primarily for cosmetic purposes.
During surgery the structure of the nasal skeleton is addressed to improve nasal breathing. Problems with nasal breathing may occur due to anatomic obstruction of the nasal passages. A deviated septum is an example of this. In addition to the septum, the nasal skeleton is made up of nasal bones, upper lateral cartilages, and lower lateral cartilages. If any of these portions of the nasal skeleton are broken or weak, they may cause obstruction of the nasal passages and lead to complaints of nasal obstruction or difficulty breathing through the nose.
Turbinoplasty aims to correct nasal turbinate enlargement. Turbinate hypertrophy is often caused by nasal allergies and is a major cause of nasal congestion or blockage.
The nasal turbinates are vascular structures inside the nasal cavity which warm the air as it enters the nose. However, when the turbinates are enlarged, their ability to keep the nose moist and warm the air is hindered.
Usually, enlarged turbinates can be treated medically.
However, if medical management fails, the turbinates can be surgically reduced in size and repositioned to allow for a larger nasal airway. The procedure aims to remove as little tissue as possible in reshaping and repositioning the turbinate.
Loss or altered sense of smell
Loss of a sense of smell can occur because of nasal blockage, sinusitis or other conditions that prevent odorants (smell particles) reaching the sensitive nerve endings that detect smell in the roof of the nose. This is called conductive anosmia. Diagnosis involves careful examination of the nose, and sometimes CT imaging. Appropriate medical treatment can often restore the sense of smell, but sometimes endoscopic sinus surgery is required to achieve the best results.
Loss of smell can also occur as a result of head injuries, or complications from a severe cold or viral infection.The delicate nerve endings of the olfactory (smell) nerves are quite prone to damage (causing sensorineural anosmia), but unlike most nerve cells in the body, the nerve cells have an ability to repair themselves. While spontaneous recovery can occur by itself, early treatment may improve recovery rates.