Chronic Nasal Congestion: What You Need to Know - Otolaryngology

Dr. Ye Dawei reply Otolaryngology

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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, and nasal congestion are extremely common.
However, due to the complex causes, treatment can be challenging, leading patients to be drawn to exaggerated advertisements promising "cure" or "guaranteed treatment." In the past two years, I have treated many patients who underwent the so-called "five-minute nasal disease cure," only to find issues such as nasal mucosal adhesions, nasal vestibule inflammation, nasal cavity narrowing, and nasal septum perforation, which are truly numerous and disheartening.

The causes of nasal congestion generally include "infection," "structural abnormalities of the nose," "allergic rhinitis," and "vasomotor rhinitis," each with its own pathogenic mechanisms and treatment approaches.
Of course, each condition has its limits in terms of treatment efficacy, which has allowed alternative traditional therapies to gain traction.
Below is a brief introduction to each condition based on this classification.
◎ Infection: The most common cause of nasal congestion is the common cold.
Once the cold resolves, the congestion typically improves.
Bacterial infections leading to sinusitis are more severe, presenting with nasal congestion, post-nasal drip, headache, difficulty concentrating, and chronic nighttime cough.
In children, this can significantly affect sleep quality and academic performance.
If conservative treatments such as medication and nasal irrigation are ineffective, surgery may be recommended.
The previously common Luc's radical surgery, which involved incising the lip to remove the entire sinus mucosa, has now been completely replaced by endoscopic sinus surgery.
Endoscopic surgery allows for selective removal of the obstructive mucosal tissue under good visualization, restoring normal sinus function.
◎ Structural Abnormalities of the Nose: Deviated septum and chronic hypertrophic rhinitis.
A "deviated septum" can occur naturally at birth due to compression or may result from trauma causing cartilage deformation.
The degree of deviation does not always correlate with nasal congestion, and the decision to surgically correct it can depend on the patient's subjective experience.
"Chronic hypertrophic rhinitis" refers to the hypertrophy of normal turbinate tissue, which can lead to nasal congestion.
The turbinates, also known as nasal conchae, are normal physiological structures located on the lateral wall of the nasal cavity, which patients can often see when examining their own nasal cavities.
Sometimes, patients are misinformed that these are nasal polyps and undergo inappropriate cauterization procedures.
◎ Allergic Rhinitis: Currently, there is no definitive cure for allergic rhinitis in medicine.
It is a disease caused by a specific predisposition, leading to edema of the nasal mucosa and resulting in nasal congestion.
Treatment can be tailored based on the severity of symptoms, using oral medications, nasal sprays, immunotherapy, or surgery to alleviate nasal congestion.
◎ Vasomotor Rhinitis: Various factors can cause vasomotor rhinitis, including work stress, hormonal changes during pregnancy, certain antihypertensive medications, and even irritants such as perfumes, temperature and humidity changes, or cooking fumes.
These factors can cause dilation and congestion of the blood vessels in the nasal mucosa, leading to nasal congestion.
Treatment options for chronic hypertrophic rhinitis, allergic rhinitis, or vasomotor rhinitis may include conservative oral medications, nasal sprays, traditional inferior turbinate resection, or advanced laser surgery.
Currently, there is also a technique using thermal probes placed submucosally in the turbinates, where radiofrequency generates low heat to cause protein coagulation in the submucosal tissue, leading to fibrosis and reduction of the hypertrophied turbinate tissue.
Nasal congestion is not classified as a disease, but it is a very bothersome symptom.
It can lead to difficulties in breathing, dizziness, headaches, lack of concentration, snoring, insomnia, or even sleep apnea.
Consulting a professional otolaryngologist to identify the true cause of nasal congestion and selecting appropriate symptomatic treatment is the right approach.
I sincerely hope to no longer see so-called guaranteed cures for nasal diseases in the clinic.

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Reply Date: 2003/12/31