Chronic Nasal Congestion: Causes, Treatments, and Solutions

Frequent nasal congestion?

Hello, doctor! I have been experiencing frequent nasal congestion in my left nostril.
Since April 1st, I have been visiting the ENT department at the hospital.
I have a history of two surgeries on my nose (for nasal polyps and chronic sinusitis), with the last surgery performed on July 14, 2015.
However, in mid-March of this year, I started feeling persistent congestion in my left nostril, along with frequent post-nasal drip, which made me worry about a possible recurrence.
Therefore, I went to the hospital for an examination in April.
Initially, the doctor diagnosed me with nasal allergies and prescribed allergy medication for three consecutive weeks, but there was no significant improvement.
Later, the doctor arranged for a CT scan to check for any growths in my nasal cavity.
During my follow-up appointment today, the doctor reviewed the CT scan report and stated that there was no recurrence at the site of my previous surgery.
However, I still experience frequent nasal congestion.
Although using a saline nasal rinse and nasal spray provides temporary relief, the congestion returns shortly after.
The doctor then examined me again and mentioned that my nasal cartilage is slightly retracted, which is causing the sensation of nasal congestion when I breathe.
Is there any way to improve this condition, or is this the best it can be? The doctor indicated that medication would not be effective for this issue, so no new medications were prescribed, and I was advised to continue using the nasal spray to alleviate the congestion.
However, since the nasal congestion continues to trouble me, are there really no other treatment options available?

Chen Chia Ling, 20~29 year old female. Ask Date: 2016/04/28

Dr. Zheng Jueyi reply Otolaryngology

Hello, if the CT scan shows no significant issues and surgery has been performed, it is generally recommended to continue using intranasal corticosteroids to manage symptoms, along with nasal irrigation.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2016/04/28

More Info

Chronic nasal congestion can be a frustrating and debilitating condition, significantly impacting your quality of life. Based on your description, it seems that you have a history of nasal surgeries and ongoing issues with nasal congestion, particularly on the left side. Let's delve into the potential causes, treatments, and solutions for your condition.

Causes of Chronic Nasal Congestion
1. Allergic Rhinitis: This is a common cause of nasal congestion, where the immune system overreacts to allergens such as pollen, dust mites, or pet dander. Symptoms can include sneezing, itching, and a runny nose.

2. Structural Abnormalities: You mentioned that your nasal cartilage is somewhat retracted, which can lead to a narrowed nasal passage. This structural issue can cause persistent congestion, especially if it affects airflow.

3. Nasal Polyps: Although your doctor indicated that there was no recurrence of polyps in the area previously operated on, it's essential to note that new polyps can develop, leading to similar symptoms.

4. Chronic Sinusitis: This condition involves inflammation of the sinuses, which can lead to nasal congestion, post-nasal drip, and facial pain. Even if your CT scan did not show significant issues, chronic sinusitis can sometimes be subtle.

5. Vasomotor Rhinitis: This non-allergic condition can cause nasal congestion due to changes in temperature, humidity, or exposure to irritants. It can be triggered by stress, strong odors, or even spicy foods.

Treatment Options
1. Medications:
- Nasal Corticosteroids: These are often the first line of treatment for chronic nasal congestion. They help reduce inflammation in the nasal passages.

- Antihistamines: If allergies are a contributing factor, antihistamines can help alleviate symptoms.

- Decongestants: These can provide temporary relief from nasal congestion but should not be used long-term due to the risk of rebound congestion.

2. Nasal Irrigation: Regular use of saline nasal sprays or rinses can help clear mucus and allergens from the nasal passages, providing symptomatic relief.

3. Allergy Management: If allergies are a significant factor, identifying and avoiding triggers is crucial. Allergy testing and immunotherapy (allergy shots) may also be beneficial.

4. Surgical Options: If structural issues are contributing to your symptoms, surgical interventions may be necessary. Options include:
- Septoplasty: To correct a deviated septum.

- Polypectomy: To remove nasal polyps if they develop.

- Endoscopic Sinus Surgery: To improve sinus drainage and address chronic sinusitis.

5. Lifestyle Modifications: Maintaining a humid environment, avoiding known irritants, and managing stress can also help alleviate symptoms.

Conclusion
Given your ongoing symptoms and the fact that medications have not provided significant relief, it may be worthwhile to seek a second opinion from another ENT specialist. They can provide a fresh perspective on your condition and explore additional treatment options. If structural issues are confirmed, surgical intervention may be the most effective way to achieve long-term relief from your chronic nasal congestion.

In the meantime, continue using your nasal spray as directed, and consider keeping a symptom diary to track any patterns or triggers that may help your healthcare provider in managing your condition more effectively. Remember, chronic nasal congestion is a common issue, and with the right approach, you can find relief and improve your quality of life.

Similar Q&A

Effective Remedies for Chronic Nasal Congestion and Headaches

I have been experiencing long-term nasal congestion, sometimes affecting one side, and I also have occasional migraines. What methods can help cure this condition or improve my symptoms? Thank you.

Dr. Hu Kexin reply Otolaryngology
Dear Mr. Chuang, There are many causes of nasal congestion, including chronic rhinitis (such as inferior turbinate hypertrophy, allergic rhinitis, etc.), deviated septum, or chronic sinusitis, all of which can lead to persistent nasal congestion and even headaches. The treatment...

Understanding Chronic Nasal Congestion: What You Need to Know

I went to see an ENT specialist because I've been suffering from nasal congestion since childhood. The doctor said I have chronic nasal turbinate hypertrophy. What does this mean, and what should I do about it? (The doctor explained, but I couldn't hear very well.)

Dr. Ye Dawei reply Otolaryngology
Xiao Wei, since I cannot see your nose, I cannot make a definitive diagnosis. However, based on your description, it seems to be chronic nasal turbinate hypertrophy. Here is an article for your reference: In the otolaryngology clinic, symptoms such as cough, headache, dizziness...

Persistent Nasal Congestion at Night: Causes and Solutions

Hello, doctor. I would like to ask why every time I lie down in bed to sleep, I feel nasal congestion, a sense of swelling, and a tingling sensation that prevents me from falling asleep. I have visited several ENT specialists, and they found no significant issues with my nose. Th...

Dr. Ji Zhaoyun reply Otolaryngology
1. Regarding allergic rhinitis, there are several important concepts: The individual's constitution and environmental allergens and irritants are the main triggering factors. If one parent has allergic rhinitis, the likelihood of their children developing allergic rhinitis i...

Chronic Right Nasal Congestion: Causes and Treatment Options Explained

Chronic nasal congestion in the right nostril with post-nasal drip, normal X-ray findings, and no improvement with medication may indicate several potential causes. These could include: 1. Chronic Sinusitis: Inflammation of the sinuses that may not always show abnormalities ...

Dr. Ye Dawei reply Otolaryngology
Mr. Chiu: As long as you have had an X-ray and confirmed that it is not sinusitis, we can only try oral medications. If you have nasal congestion, laser or traditional surgery can be considered. However, the issue of post-nasal drip may not necessarily improve. Please refer to th...