Breathing Difficulties Due to Deviated Nasal Bone: What to Do?

Hello doctor, regarding the issue of a deviated nasal bone causing breathing difficulties?

Hello Doctor,
I have a complex and uncomfortable situation and would like to seek your advice and guidance on where to seek treatment.
When I was 14 years old, a classmate kicked a water-filled plastic bottle in the classroom, which hit me on the left side between the bridge of my nose and the root of my nose (about 5 cm below the inner corner of my eye).
At that time, I had an open wound and severe bleeding.
Two years ago, at the age of 35, I sought medical attention due to difficulty breathing.
An otolaryngologist informed me that my right nasal passage is relatively narrow and that my nasal bone is crooked.
When I use a cotton swab to probe inside my nose, I can clearly feel the difference in width between the two sides.

I am now 37 years old, have a history of diabetes, have not contracted any infectious diseases, and weigh 96 kg.
Over the past two years, I have frequently experienced difficulty breathing and a sensation of air not being able to enter my lungs.
During severe episodes, I feel chest tightness and dizziness.
Could this be related to the incident I described or to my diabetes and obesity? Which specialty should I consult, and what steps should I take? I have already seen specialists in otolaryngology and pulmonology in my area, but I have not experienced any improvement.
I am unsure if my description is too vague or if I am seeking treatment in the wrong direction.

Thank you very much for your help.

Axiang, 30~39 year old female. Ask Date: 2022/05/29

Dr. Ji Zhaoyun reply Otolaryngology

Hello, regarding the part you mentioned, it is indeed possible that both otolaryngology and pulmonology are related.
Here, I will explain the otolaryngology aspect concerning nasal bone fractures that lead to a deviated nose and a deviated nasal septum.
If treatments such as medication and nasal irrigation are ineffective, surgical intervention may be considered.
If needed, you can consult an otolaryngologist with expertise in facial and nasal reconstruction.
Wishing you peace and good health.

Reply Date: 2022/05/29

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your breathing difficulties and the history of nasal trauma. Based on the information you've provided, it seems that your symptoms may be linked to a combination of factors, including the deviated nasal bone from your childhood injury, potential complications related to your diabetes, and possibly your weight.

Firstly, the injury you sustained at the age of 14 could have led to a deviated septum or misalignment of the nasal bones. A deviated septum occurs when the cartilage and bone that divide the nasal cavity are off-center or crooked, which can lead to chronic nasal obstruction. This obstruction can significantly impair airflow through the nasal passages, making it difficult to breathe through your nose and potentially leading to mouth breathing, which can cause dryness and other complications.

Your history of breathing difficulties over the past two years, along with the sensation of air not reaching your lungs, suggests that there may be a significant structural issue within your nasal passages. The fact that you have been evaluated by both an ENT (ear, nose, and throat) specialist and a pulmonologist without improvement indicates that further investigation may be necessary. It’s important to ensure that there are no other underlying conditions contributing to your symptoms, such as asthma or other respiratory issues, especially given your history of asthma in childhood.

Additionally, your diabetes and weight can also play a role in your respiratory health. Obesity can lead to a condition known as obstructive sleep apnea, which can cause breathing difficulties during sleep and may contribute to daytime fatigue and other symptoms. Diabetes can also affect circulation and nerve function, potentially complicating respiratory issues.

Given your complex history, I would recommend the following steps:
1. Consultation with a Facial Plastic Surgeon or ENT Specialist: Since you have already seen an ENT specialist, consider seeking a second opinion from a surgeon who specializes in nasal reconstruction or functional rhinoplasty. They can assess the structural issues in your nasal passages and determine if surgical intervention is necessary to correct the deviation and improve airflow.

2. Pulmonary Function Tests: If you haven’t already, ask your pulmonologist about conducting pulmonary function tests. These tests can help assess your lung capacity and function, providing insight into whether your breathing difficulties are primarily due to nasal obstruction or if there are underlying lung issues.

3. Weight Management: If you are overweight, working with a healthcare provider to develop a weight management plan could be beneficial. Weight loss can improve overall respiratory function and reduce the risk of complications associated with obesity.

4. Allergy Testing: If you have not been tested for allergies, consider this as well. Allergies can contribute to nasal congestion and breathing difficulties, and managing them may improve your symptoms.

5. Lifestyle Modifications: Implementing lifestyle changes such as regular exercise, a balanced diet, and stress management techniques can also help improve your overall health and potentially alleviate some of your breathing difficulties.

In conclusion, your breathing difficulties may stem from a combination of structural issues due to your past injury, your diabetes, and your weight. It is crucial to pursue further evaluation and possibly surgical options to address the deviated nasal bone and improve your quality of life. Please ensure you communicate all your symptoms and concerns clearly to your healthcare providers, as this will aid in developing an effective treatment plan.

Best wishes for your health and recovery.

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