At this time of year, with the weather becoming more cold and damp, it is often when we start to feel ‘congested’ in the nose and ears. These issues are often compounded by the lingering after effects of cold and flu viruses that are at their worst in the winter.
A persistent blocked and congested nose can result in the following side effects:
- A consistent headache
- Discharge from the nose
- Decreased or loss in sense of smell
- Blockage of the Eustachian Tube at the back of your nose – this may give you a feeling of blocked/muffled ears (similar to when you’re on a plane)
- Poor hearing and tinnitus which is when you hear ‘internal’ noises in the ears not produced by an outside source
All these symptoms can have a frustrating and significant negative effect on your quality of life, but if investigated and treated early, can often be easily and rapidly cured without the need for surgery.
What can block my nose?
There are generally two causes for a blocked nose:
Firstly, a structural problem with the nasal passages such as a deviation in your nasal septum (partition) or secondly, swelling of the nasal and sinus lining (also called rhinosinusitis) These issues may coexist.
Persistent rhinosinusitis and swelling of the nasal lining after a cold or virus is the commonest cause of a blocked nose in the winter months, and as part of this, two scroll-shaped nasal structures inside the nose called inferior turbinates may swell so significantly that they block the whole nose.
In extreme cases, if the nose and sinus lining become extremely swollen, nasal polyps may form within the sinuses. If these continue unchecked, they may outgrow the sinuses themselves and poke down into the inside of your nose, severely narrowing your breathing passage. If they get big enough, polyps may even poke out through the nostrils themselves so you can see them!
How can a blocked nose be investigated?
We believe the key to treatment of these issues is fast, accurate and careful investigation and diagnosis. This will involve listening carefully to your symptoms in detail and investigating them without delay, by looking up your nose with a very fine camera or endoscope to accurately see what is going on.
An endoscopy of the nose can be done in 30 seconds using local anaesthetic if required, but in the vast majority of cases no anaesthetic is needed as it is painless.
The next investigation is often a CT scan of your sinuses arranged as an outpatient to confirm the diagnosis of what is going on in the depths of the sinuses themselves.
If you have associated problems with your ears, we have expert Audiologists who can carry out specialist hearing tests for you on the day of your visit too.
Sometimes if the problem sounds to be related to an allergy we may arrange some appropriate blood tests to see exactly what it is you are allergic to, as the optimal treatment for this is the knowledge to be able to avoid the particular issue causing the allergy in the first place.
This allows us to give you an accurate and thorough idea of what is going on in your nose and your ears and to precisely plan what is required to treat it for you.
How can a blocked nose be treated?
The most common cause of blocked nose is swelling of the lining of the nose and sinuses (termed ‘Rhinosinusitis’), and this may be due to ‘allergic’ or ‘non-allergic’ causes.
In cases of an allergic problem, treatment is centered on avoidance of the allergen concerned once it has been diagnosed, as well as antihistamine tablets and steroid nasal sprays. More modern combination steroid and antihistamine sprays may be helpful too.
In non-allergic cases (where no obvious allergen is present), cases are often due to persistent infection in the nose and sinuses, often starting with a viral infection that never fully clears. In general, these cases are usually managed by a combination of steroid nasal sprays, saline nasal douching and specific antibiotics, sometimes given for extended periods but carefully supervised.
What happens if medical treatments don’t work?
If we can see particular structural issues inside the nose, or if the problems with the nasal lining outlined above do not get better with appropriate medical treatment, you may need surgery.
We can discuss all the best surgical options targeted to your individual problems if this is appropriate in your case.
All the surgery described below is undertaken as a day case under a short general anaesthetic (which means you are asleep throughout.)
The aim is a rapid improvement of your symptoms and a speedy return to work and normal life.
- Septoplasty can correct a bent partition between the two nostrils so as to improve the nasal passages. This can be combined with Inferior Turbinate Reduction if appropriate, to reduce the size of the inferior turbinates to give more space inside the nose to breathe
- Functional Endoscopic Sinus Surgery (FESS) is surgery performed inside the nostrils to open the sinuses, remove polyps if they are present, and as a result allow the sinuses to drain much more effectively to prevent the symptoms of headache, congestion and recurrent sinus infections
- Balloon Eustachian Tuboplasty is an exciting new procedure to open the Eustachian Tube via the nostril under endoscopic guidance. This balloon stretches the Eustachian Tube open so that the middle ear is able to ventilate itself much more effectively in the future
To find out more, or to book an appointment, please complete our online form or call our Private Patient team on 01580 363158.
Published on 13 November 2021