Nasal Congestion: Causes and Solutions for Better Breathing - Otolaryngology

Dr. Ye Dawei reply Otolaryngology

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The causes of nasal congestion can be attributed to "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 therapeutic efficacy, which has allowed alternative traditional therapies to gain popularity.
Below is a brief introduction to each condition based on this classification.
◎ Infection: The most common cause of nasal congestion is the common cold, which resolves naturally once the cold is cured.
Bacterial infections leading to sinusitis are more severe, presenting not only with nasal congestion but also with post-nasal drip, headaches, difficulty concentrating, and chronic nighttime coughing.
This can significantly affect children's sleep quality and academic performance, making it a considerable concern.
If conservative treatments such as medication and nasal irrigation are ineffective, doctors may recommend surgical intervention.
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 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 distortion.
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 may cause nasal congestion symptoms.
The turbinates, also known as nasal conchae, are normal physiological structures located on the lateral walls of the nasal cavity, which patients can often observe themselves.
Sometimes, patients may be misinformed that this is 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, utilizing 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 lead to dilation and congestion of the blood vessels in the nasal mucosa, resulting in nasal congestion symptoms.
Treatment options for chronic hypertrophic rhinitis, allergic rhinitis, or vasomotor rhinitis may include conservative oral medications, nasal sprays, traditional inferior turbinate reduction surgery, or advanced laser surgery.
There is also a newer technique involving the placement of thermal needles beneath the turbinate mucosa, using radiofrequency to generate low heat, causing protein coagulation in the submucosal tissue, leading to fibrosis and reduction of hypertrophied turbinate tissue.
Nasal congestion itself is not classified as a disease but is a highly bothersome symptom.
It can lead to dizziness, headaches, difficulty concentrating, snoring, insomnia, or sleep apnea.
Consulting a professional otolaryngologist to identify the underlying cause of nasal congestion and selecting appropriate symptomatic treatment is the right approach.
We sincerely hope that we will no longer see so-called "cure-all" nasal disease treatments in outpatient clinics.
Dr.
Yeh Da-Wei, Director of the ENT Department, Hsinchu Hospital.

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Reply Date: 2008/01/30