A blocked nose is a very common complaint and can be caused by several different situations :
- If the middle partition (the septum) of the nose is not straight it may veer to one side causing blockage of that side. Patients often say that one side of the nose is constantly blocked. This requires an operation to correct but is usually very successful
- If the side walls of the nose have overgrown ( turbinate hypertrophy) this can block the nose and the sinus openings. This can produce not only a blocked nose but repeated sinus infections (recurrent sinusitis) This is often present when the septum is not straight. It requires surgery to correct which, if required, can be performed at the same time as a septoplasty.
- Allergic rhinitis is a condition where the lining of the nose swells due to inhaled allergens. These can be seasonal (hayfever) or all year long (perennial rhinitis). Treatment is usually with medications rather than surgery.
- Nasal polyps are outgrowths of the nasal lining which block the nose. They usually form over several years and the vast majority of swellings in the nose are benign. They can be treated with oral or nasal steroids and if this is ineffective, surgery is very successful.
- Following trauma to the nose there can be changes to the shape of the septum, cartilages and bone which make up the nasal structure. In these cases, an operation to correct the deviated septum (septoplasty) may not be enough. The operation is therefore designed to correct not only the septum but also the nasal bone and cartilage deviation ( a septorhinoplasty).
Before any surgery is performed it is important to get a correct diagnosis. This requires a careful history taking of symptoms present.
Examination includes a fibreoptic nasopharyngolaryngoscopy. This is an endoscopic examination of the inside of the nose and the passages leading to the vocal cords. It is performed in the outpatient clinic and allows the visualisation of any part of the airway which will require correction.
If allergies are suspected, skin prick testing is used to find out what allergen(s) is likely to be causing the problem.
If the sinuses are to be operated on a CT scan is needed.
Surgery will usually take between 30 mins and 2 hours depending upon which of the above problems is found in the pre operative assessment. Most patients stay in hospital for one night and go home the next morning.