BLOCKED NOSE

Treatments for blocked nose sufferers

Symptoms

Causes of Blocked Nose

Mike Dilkes provides treatment for nose blockage, including laser turbinoplasty under local anaesthetic, in the clinic.

Read more about common blocked nose problems below and understand blocked nose treatments including laser turbinoplasty under local anaesthetic. A full breakdown of prices for nose unblocking, septoplasty and laser turbinoplasty can be found here. Also see our blocked nose FAQ page for answers to common questions.

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Mike Dilkes, ENT Surgeon | www.mikedilke

"Great doctor. My nose surgery was done very well and I can breathe much easier. Michael has a great demeanour towards his patients - calm, understanding and knowledgeable, making you feel at ease.”

— Egbertukash

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—Barbara Ratcliffe

Blocked Nose Problems

Causes

Blocked nose problems

Having a blocked nose is a very common symptom in the adult population of the U.K. It is often difficult to tolerate for many patients, since they have to breathe through their mouth much of the time. This can cause excessive dryness, which damages the gums, and sometimes causes drooling. Chronic mouth breathing is also bad for the lungs and may also precipitate tonsil problems.

Mouth breathers tend to be slow, noisy eaters and the blocked feeling itself is often highly off-putting, affecting the ability to exercise and function normally. Sense of smell and taste can also be affected.

Snoring is common in those with a blocked nose, as an open mouth causes the mandible (jaw bone) to move backwards. This means the tongue, which is attached to the mandible, also moves backwards, thus obstructing the space behind the tongue — which is by far the commonest site for snoring sound initiation.

Nose blockage may also be associated with sneezing and a runny nose (rhinitis). The “Nasal Cycle” always means that one side of the nose will be open, the other relatively blocked, from time to time and side to side during the day and night. The problem therefore arises when the side that should unblock during the nasal cycle, can’t. Then the nose becomes totally blocked. Allergy, humidity, air temperature, stress, etc., can all be associated with a blocked nose.

The paranasal air sinuses (“sinuses”) are commonly diseased when the nose is not functioning properly, causing acute and chronic sinusitis, post-nasal drip, bad taste and smell, plus a chronic dry cough.

Indications for blocked nose surgery

We perform surgery for nose blockage when medical therapy has been exhausted, or when the patient feels he or she does not want to take medication for a lifetime.

How are blocked noses caused?

There are many causes of a blocked nose. The three commonest ones are allergy, a deviated nasal septum and chronic rhino-sinusitis.

Blocked nose caused by allergy

Treatment usually starts with simple application of steroid or antihistamine sprays, or a combination of the two. Anti-cholinergic sprays may help when the main symptom is a runny nose. If initial advice and sprays have not solved the problem, the next stage in treatment is with tablets containing antihistamines, anti-leukotrienes or steroids. Depot injections of steroids can be given in chronic conditions such as nasal polyps. Allergen (what you are actually allergic to) avoidance is a vital part of treatment, so allergy testing is a must. In cases of severe specific allergy, a desensitisation course can also be tried. Allergy testing can take many shapes – see the section on allergy.

Blocked nose caused by trauma

Deviation of the nasal septum is caused by trauma. The actual incident may not be recollected by the patient. It can be part of birth canal trauma when you are born. Symptoms of nose blockage due to this tend to appear as we get older, even though the damage may have been caused at an earlier age.

Blocked nose caused by sinus disease

Sinus disease occurs due to obstruction of the normal sinus outflow tract from the para nasal air sinuses into the nose. This outflow tract clears mucous produced by the sinuses, through tiny holes (ostia) into the nose cavity, where they are cleared by passage backwards into the throat, and swallowing. Over a litre a day of mucous is produced by the nose and sinuses. Over-production causes symptoms of postnasal drip and chronic cough. Nose polyps can be a side effect of this, and they cause complete nose blockage with loss of sense of smell. Acute sinusitis occurs when the ostia are blocked (e.g. after a cold), fluid then builds up in the sinuses, which subsequently becomes infected. This type of infection can be very serious, sometimes life-threatening.

BLOCKED NOSE TREATMENTS

Spire Roding Hospital, Mike Dilkes ENT L

BLOCKED NOSE

FREQUENTLY ASKED QUESTIONS

Blocked Nose Treatments

Sinuplasty

Septoplasty

Turbinectomy

Blocked Nose Treatments

Septoplasty - Surgical Treatment of Blocked Nose

This is quite a common procedure, where a bent nasal septum is corrected. It is a day treatment under a short general anaesthetic. Our readmission rates and overnight stay rates are less than 1%. Successful unblocking occurs in most patients after one attempt, although a small percentage (around 1:25 patients) need a second procedure. Antibiotics are prescribed post-operatively to prevent infection or bleeding. Return to work is usually around 48 – 72 hours post treatment. Painkillers are not usually required post-operatively. There are no black eyes or cuts on the outside, as it’s all done internally.

Patients hate having packs removed from the nose after surgery. We do away with this by using laser techniques on the turbinates (which would otherwise be prone to bleeding), so usually NO packs are required. If we do use them, dissolving packs are inserted - so they don't have to be removed. It is like having a cold afterwards, as the nose tends to swell up a bit inside for about 1 week post-op. This is alleviated by using decongestant (Otrivine) sprays, and salt water douches (Sterimar) - both supplied when you leave Hospital.

Turbinoplasty - Laser Reduction of the Inferior Turbinates

The inferior turbinates are bony structures covered by nasal lining, which protrude into the nose and can be a cause of nose blockage. The main technique for reduction of the inferior turbinate is called Turbinoplasty. This is performed under local or general anaesthetic, and uses the Holmium-YAG laser to damage and remove part of the inferior turbinate bone. This is a more permanent procedure than other techniques to reduce the inferior turbinate, as the bone does not regrow. It also avoids the (rare) problem of empty nose syndrome as the lining is not removed at all. Nose packs are generally not needed and patients can return to work the same day if it’s the local anaesthetic technique, or after 48 hours if it’s the general anaesthetic. This procedure works by altering the function of nose breathing receptors, and reducing the size of the inferior turbinates - large structures which sit inside the nose, attached to the side wall. Reduction of the size of these structures increases the size of the breathing channel and reduces the ability to sense blockage.