What is a blocked nose?

A blocked nose or nasal obstruction is a sensation of blockage or inadequate airflow through the nose. It is a very common complaint, affecting 1 in 4 people in urban areas.

What causes nasal obstruction?

Common causes of nasal blockage include nasal allergies, a deviated septum and sinus disease such as nasal polyps. Less commonly, nasal blockage may be caused by more serious abnormalities such as nasal tumours. A constantly blocked nose can have a significant impact on a person’s quality of life and wellbeing.

How is nasal obstruction diagnosed?

An examination of the nose including fibre-optic examination using a small endoscope will usually identify the cause of the obstruction.

Investigations such as allergy testing, CT scans and measurements of nasal airflow may also be required.

What is the treatment for nasal obstruction?

Successful treatment of nasal obstruction depends on the underlying cause. Some conditions benefit from medical therapy such as saline nasal washes and nasal steroid sprays. These act to remove irritants from the nose and reduce inflammation or swelling of the nasal lining.

Surgery may be considered for structural causes of nasal obstruction such as a deviated septum or for patients with co-existing sinus disease such as chronic sinusitis or nasal polyps. Your WestsideENT specialist will discuss the results of all investigations and your treatment options with you during your consultation.

What is Hay Fever?

Hay Fever is also known as seasonal allergic rhinitis. It is caused by an allergic response to things that you breath in such as pollens, dust mites, animal hair or moulds. This causes irritation and swelling of the lining of the nose and an increase in mucous production.

Hay fever can have a significant impact on school and work performance as well as sleep quality. The cost of allergy related disease to the Australian economy is in excess of 1 billion dollars each year.

How is it diagnosed?

People with allergic rhinitis usually experience symptoms similar to a head cold such as a runny nose, itchy eyes, congestion and sneezing attacks. Examination of the nose including fibre-optic examination using a small telescope shows swelling of the tissues on the side wall of the nose. Allergy testing may be done to confirm the diagnosis and identify the allergens involved.

What is the treatment?

Minimizing exposure to the allergens that cause your symptoms is an essential part of managing hay fever. Medications are also very effective in the management of nasal allergies. These include nasal steroid sprays, antihistamines and decongestants. The best relief is often obtained from using a combination of allergy medications. Nasal steroid sprays help prevent and treat nasal inflammation and are the most effective medication for many people.

Antihistamines can help with sneezing and a runny nose.

Decongestants are available orally or as a nasal spray. Decongestant nasal sprays are designed for short term use and can make your symptoms worse with prolonged use. Nasal saline washes can also be beneficial as they relieve congestion and flush out allergens from your nose.

Your WestsideENT specialist will discuss these and other treatment options with you during your consultation.

What are the sinuses

There are four pairs of sinuses in the face and head located around the nasal cavities. The sinuses aid in the resonance of your voice and along with your nose, help to warm and humidify the air that you breathe. They are lined with the same tissue as your nose and are connected to the nasal cavity through small narrow openings.

What is sinusitis?

Sinusitis can occur if swelling of the lining of the nose and sinuses results in blockage or obstruction of these small openings. This results in nasal obstruction or congestion, mucous discharge from the front of the nose or the back of the nose, also known as post nasal drip, facial pain or pressure and decreased sense of smell.

Sinusitis may be acute or chronic, depending on the duration of symptoms. While the symptoms of acute and chronic sinusitis are similar, acute sinusitis resolves fairly quickly whereas chronic sinusitis persists longer than 12 weeks, despite appropriate treatment.

Acute Sinusitis

Acute sinusitis is a temporary infection usually preceded by a cold or flu. The symptoms of acute sinusitis respond to home remedies and medical treatment. The symptoms are short lived and usually resolve within a week or two.

Chronic sinusitis

Chronic sinusitis is a common condition with the potential to severely impact on your quality of life. The symptoms of nasal obstruction or congestion, mucous discharge from the front of the nose or the back of the nose, also known as post nasal drip, facial pain or pressure and decreased sense of smell are present for greater than 12 weeks, despite treatment.

It is important to be aware that headaches and pain in the face may not be due to sinus disease. Many other medical conditions can present with face pain, headaches and sinus like symptoms.

What causes chronic sinusitis?

Chronic sinusitis usually occurs due to a combination of factors acting together. These include anatomic abnormalities such as a deviated septum or narrow sinus openings. Respiratory tract infections, allergies such as hay fever and nasal polyps are other contributing factors. Regardless of the cause, the sinus lining becomes inflamed and swollen and the sinus openings become obstructed.

How is chronic sinusitis diagnosed?

Chronic sinusitis is diagnosed by having symptoms of sinusitis for longer than 3 months along with evidence of sinus disease during a fibre-optic examination of your nose with a small endoscope or evidence of sinus disease on a CT scan of the sinuses. Other investigations may include an MRI scan or allergy testing.

What is the treatment?

Chronic sinusitis is a long-term disease, often requiring a combination of treatments over time. Long term medical therapy is successful in many cases in reducing symptoms and improving quality of life.

If symptoms persist despite adequate medical treatment, sinus surgery may be indicated.

The aim of sinus surgery is to reduce the amount of diseased mucous lining and enlarge the sinus openings into the nose. This allows better delivery of saline rinses and medications to the sinuses, which usually have to be continued long term.

Your WestsideENT specialist will discuss treatment options tailored for you during your consultation.

What is a broken nose?

A broken nose is a fracture involving the bones forming the bridge of the nose following an injury to your nose. The injury can also damage the skin and cartilage of the nose.

What to do and expect?

If you have broken your nose, you will have pain, swelling and bruising around your nose and bleeding from the nose. Your nose may also be crooked and you may have difficulty breathing through your nose.

If you suspect that you have broken your nose, see your general practitioner to make sure that you don’t have complications such as a septal haematoma (collection of blood under the lining of the septum).

What is the treatment of a broken nose?

Apply ice packs immediately after the injury and continue for 1-2 days to reduce swelling. An x-ray of your nose is usually unnecessary as it does not help in the decision making process. Other scans are only indicated if more serious injuries are suspected.

Swelling usually takes 5-7 days to resolve so it is best to wait for a week or so before seeing an ENT surgeon as swelling prevents an accurate assessment of whether your nose is misshapen.

If your nose remains crooked or deformed after the swelling has subsided then realignment of the displaced bones should be considered.

This will need to take place within 14 days of the injury as the bones start to set after that time, reducing the likelihood of achieving a good result.

Your WestsideENT specialist will discuss your treatment options with you during your consultation.

What are nasal polyps?

Nasal polyps are grape like swellings of the mucous lining of the nose or sinuses resulting from chronic inflammation of the lining. Nasal polyps usually occur with chronic sinusitis but it is more common to have chronic sinusitis without nasal polyps.

What causes nasal polyps?

We don’t fully understand what causes nasal polyps as we don’t know why chronic inflammation of the sinonasal mucous lining triggers polyp formation in some people but not others. It is thought that people who form polyps have a different immune response to inflammation than those who do not form polyps.

Any condition which triggers chronic inflammation may therefore be a risk factor for polyp formation. eg infection, allergy and exposure to environmental irritants.

Nasal polyps are also associated with some specific medical conditions such as asthma, fungal allergy and aspirin sensitivity.

How are nasal polyps diagnosed?

People with nasal polyps commonly experience nasal obstruction, a reduced or absent sense of smell, a runny nose, post nasal drip and facial pressure.

Examination of the nose including fibre-optic examination of the nose using a small endoscope will reveal polyps, if present.

A CT scan is commonly performed. An MRI scan may be done if the polyps appear unusual or suspicious in which case a biopsy may also be required. Allergy testing may also be done.

How are nasal polyps treated?

Chronic sinusitis with nasal polyps is a long term disease requiring a long-term treatment plan as nasal polyps have a high rate of recurrence.

Treatment may involve a combination of medical and surgical therapy. Your WestsideENT specialist will discuss these various treatment strategies with you during your consultation.