Chronic Nasal Congestion: Causes, Treatments, and Concerns

Q: Chronic Nasal Congestion: Causes, Treatments, and Concerns

Hello, in response to your questions, here are the answers： 1. Radiofrequency or laser treatment for hypertrophic rhinitis only targets the inferior turbinate and does not address the deviation of the nasal septum. 2. The choice of surgical procedure should pr

Concerns about nasal congestion?

About a year ago, I have been experiencing nasal congestion.
I have visited many clinics, both traditional and Western medicine.
Prior to the ongoing congestion, I had intermittent episodes, but medication provided some relief.
Now, even after taking medication, there is little improvement; it seems ineffective.
Smaller hospitals advise against surgery, while larger hospitals recommend it.
The issue is that the medications from the smaller hospitals are not working for me.
I am really confused.
The last time I visited a Chinese medicine clinic, the doctor diagnosed me with allergic rhinitis, hypertrophic rhinitis, and a deviated septum.
Both doctors suggested that traditional surgery is necessary for a more thorough resolution.
I find my symptoms quite strange.
I usually do not breathe through my mouth while sleeping, as I dislike it (sometimes my nose feels blocked, but I can't tell).
My symptoms include: 1.
Nasal congestion 2.
Nasal congestion 3.
Nasal congestion...
Yes, nasal congestion has taken up a significant part of my life.
4.
Nasal congestion is particularly severe at night, but there is no obvious blockage on both sides; it usually blocks one side continuously.
5.
Sometimes, even after sleeping for ten hours, I still feel fatigued and lack motivation.
6.
Standing or exercising provides slight relief from nasal congestion, but I often experience "exercise-induced dizziness" due to it.
7.
I have had insomnia several times due to nasal congestion (sleeping at 1, 2, 3, or 4 AM is common).
8.
Sometimes when I stand up, my mind "pauses for 5 seconds." 9.
I have been continuously taking medication and using nasal sprays, but it seems to have "little effect." 10.
I have never been able to concentrate.
11.
I have tried to increase my exercise frequency, but it has not helped.
Strangely, my allergy index is 520, but I do not experience the typical symptoms of allergic patients, such as frequent sneezing or a runny nose in the morning.
Over the past year, I have sneezed less than ten times and have hardly had to blow my nose for clear nasal mucus.
I often feel like there is some mucus stuck in my nose, which is somewhat uncomfortable.
I would like to ask: 1.
If I only use radiofrequency or laser treatment for hypertrophic rhinitis, will it recur due to the deviated septum? 2.
Should I opt for traditional surgery for hypertrophic rhinitis and a deviated septum, or radiofrequency or laser treatment? 3.
What percentage of patients have both hypertrophic rhinitis and a deviated septum? 4.
What would happen if nasal congestion is resolved with ephedrine? 5.
Does exam stress affect nasal congestion or trigger allergic reactions? 6.
Please give me some advice.
I hope you won't make my article public.
Thank you once again for taking the time to read my lengthy and extensive message.
You must be an excellent doctor.

Lin Xiansheng, 10~19 year old female. Ask Date: 2005/07/18

Dr. Hu Kexin reply Otolaryngology

Hello, in response to your questions, here are the answers:
1.
Radiofrequency or laser treatment for hypertrophic rhinitis only targets the inferior turbinate and does not address the deviation of the nasal septum.

2.
The choice of surgical procedure should primarily be based on the recommendations of the physician who is clinically managing your case, as they are most familiar with your condition.

3.
I have not seen this report, so I cannot provide an accurate calculation.

4.
Nasal congestion should not be managed long-term with ephedrine.

5.
Exam stress can potentially affect nasal congestion or trigger allergic reactions.

6.
I recommend that you address your nasal congestion promptly to avoid complications.

7.
I will not disclose your article.

Best regards,
Hukeshin

Reply Date: 2005/07/18

More Info

Chronic nasal congestion can be a frustrating and debilitating condition, affecting your quality of life significantly. Based on your description, it seems you are experiencing a combination of allergic rhinitis, hypertrophic rhinitis, and a deviated septum. Each of these conditions can contribute to nasal obstruction and discomfort, and understanding their interplay is crucial for effective management.

Causes of Chronic Nasal Congestion
1. Allergic Rhinitis: This condition is triggered by allergens such as pollen, dust mites, or pet dander. Symptoms typically include sneezing, itching, and nasal congestion. However, in your case, it seems that you do not experience the classic symptoms of allergic rhinitis, such as frequent sneezing or clear nasal discharge.

2. Hypertrophic Rhinitis: This refers to the enlargement of the nasal turbinates, which can obstruct airflow and lead to chronic nasal congestion. This condition can be exacerbated by allergies, irritants, or chronic inflammation.

3. Deviated Septum: A deviated septum can cause one side of the nasal passage to be narrower, leading to chronic congestion, especially when lying down or during sleep.

Treatment Options
1. Medications: You mentioned using nasal sprays and oral medications without significant relief. Common treatments include antihistamines, corticosteroids, and decongestants. If these are not effective, it may be worth discussing alternative medications or combinations with your healthcare provider.

2. Surgical Options:
- Traditional Surgery: This may involve correcting the deviated septum (septoplasty) and reducing the size of the turbinates (turbinate reduction). This approach is often recommended for patients with significant structural issues contributing to their symptoms.

- Minimally Invasive Techniques: Procedures like radiofrequency ablation or laser treatment can reduce turbinate size with less recovery time. However, if the underlying issue of a deviated septum is not addressed, symptoms may return.

3. Allergy Management: Since you have a high allergy index, it may be beneficial to explore allergy testing and immunotherapy (allergy shots) to reduce your sensitivity to allergens.

Addressing Your Specific Questions
1. Will radiofrequency or laser treatment for hypertrophic rhinitis lead to recurrence due to a deviated septum? Yes, if the deviated septum is not corrected, it can lead to ongoing issues with nasal obstruction, even after turbinate reduction.

2. Should I opt for traditional surgery or minimally invasive techniques? This decision should be based on the severity of your symptoms, the degree of obstruction caused by the deviated septum, and your overall health. A thorough evaluation by an ENT specialist can help determine the best approach.

3. What percentage of patients have both hypertrophic rhinitis and a deviated septum? While specific statistics can vary, studies suggest that a significant portion of patients with chronic nasal obstruction have both conditions. It is not uncommon for these issues to coexist.

4. What happens if I use pseudoephedrine for nasal congestion? Pseudoephedrine can provide temporary relief from nasal congestion by constricting blood vessels in the nasal passages. However, it is not a long-term solution and can have side effects, including increased heart rate and blood pressure.

5. Can exam stress affect nasal congestion or trigger allergies? Yes, stress can exacerbate nasal congestion and may trigger allergic reactions in some individuals. Stress management techniques, such as mindfulness or relaxation exercises, may help alleviate symptoms.

Conclusion
Chronic nasal congestion is often multifactorial, and a comprehensive approach is necessary for effective management. It is essential to work closely with an ENT specialist who can evaluate your specific situation, recommend appropriate treatments, and monitor your progress. Additionally, addressing any underlying stress or anxiety may also contribute to symptom improvement. Remember, you are not alone in this journey, and with the right support and treatment, relief is possible.

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