Disorders of nasal breathing

Specialty of Otolaryngology / ENT

What are disorders of nasal breathing?

Nasal breathing disorders are relatively common and mainly cause difficulties in breathing properly through the nose.

The most common nasal breathing disorders include:

  • Sinusitis – swelling of the sinuses due to infection.
  • Deviated septum – the nasal septum (the bone and cartilage that divides the nasal cavity is crooked, which makes breathing difficult.
  • Nose / sinus trauma due to injury – for example, a broken nose that has not healed properly can cause chronic nasal breathing issues.
  • Nasal Valve Collapse (NVC) – when nasal tissues are not formed correctly or are weak, creating difficulty breathing through the nose.

What are the symptoms?

The symptoms vary for each disorder.

Sinusitis –

  • Pain and tenderness around the cheeks, eyes and forehead
  • Blocked nose
  • Green or yellow mucus
  • Headache
  • High temperature
  • Bad breath
  • Reduced sense of smell

Deviated septum –

  • Facial pain
  • Nosebleeds
  • Loud breathing
  • Snoring
  • Headache
  • Runny nose

Nose / sinus trauma due to injury

  • Congestion and difficulty breathing through the nose

Nasal Valve Collapse (NVC)

  • Nasal obstruction
  • Nosebleeds
  • Congestion and difficulty breathing through the nose

What causes nasal breathing disorders?

Sinusitis is most often caused by an infection. It can also be caused by a common cold, allergic rhinitis (which causes the lining of the nose to swell), nasal polyps on the lining of the nose or a deviated septum. Sinusitis is very common and it is very common to have sinusitis following a cold of the flu.

A deviated septum is usually something some people are born with, but it can also be caused by trauma or injury to the nose.

Nasal Valve Collapse can be caused by:

  • Rhinoplasty (nose job) – plastic surgery to the nose, for example, removing the nose hump can cause NVC.
  • Deviated septum – a very common cause of NVC which can result from nasal injury or surgery.
  • Trauma or nose surgery – due to inflammation, swelling or the formation of scar tissue.
  • Inherited anatomical characteristics – for example, noses that are over-projecting, have narrow nostrils and a wide columella (the exterior part of the nose that separates each nostril) can result in NVC naturally.

What is the treatment?

Sinusitis -

Treating simple sinusitis does not usually involve seeing a doctor, and doing the following will usually clear it up:

  • Plenty of rest
  • Keeping hydrated
  • Painkillers
  • Steaming your face over a bowl of hot water
  • Using an over-the-counter decongestant nasal spray

If sinusitis persists, a doctor may prescribe antibiotics, for a course of usually 10 to 14 days.

For those suffering from chronic sinusitus, a warm compress to the nose, saline nose drops and prescribed steroids can help.

Deviated septum –

In some cases, the symptoms caused by a deviated septum can be relieved by medication. However, if this is not the case, then a surgical procedure called a septoplasty might be recommended. This procedure restores the crooked septum to improve nasal breathing. A septoplasty involves the removal of excess bone and cartilage and is sometimes performed under general anaesthetic. This procedure is often combined with a rhinoplasty to imporve the appearance of the nose.

Nasal Valve Collapse –

There are two key approaches to treating NVC:

  • Surgery (rhinoplasty) is carried out to repair the collapsed nasal valve. Sometimes a special implant, made of titanium is required to hold the nasal valve open.
  • Nasal valve dilator – for those who do not wish to undergo surgery, using a nasal valve dilator to manually widen the nasal valve can provide nasal breathing relief. These can either be in the form of stick-on strips that you wear across the bridge of your nose. They can also be special silicon inserts that are worn internally. 
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