Nose and sinuses
My nose has been blocked for years and sprays don't help
Blocked nose treatment in KPHB, Hyderabad
Most blocked noses can be opened. It starts with a proper look inside, which takes a minute.
Does this sound like you?
- One side blocked all the time, or a block that swaps sides
- Mouth-breathing at night, a dry mouth in the morning
- Sprays that work for a while, or never did
- Snoring, poor sleep
- Blocked since an injury to the nose
Blocked nose treatment at Sinocare ENT Hospital, KPHB Colony, Kukatpally, starts with a thin camera (an endoscope) in the chair, not another spray. A nose that has been blocked for years is one of the commonest things seen here. It is also one of the most rewarding, because most of them can be opened. A nose blocks for four usual reasons, and they are often combined. It can be a bent wall between the nostrils (the septum), or swollen shelves on the side walls (the turbinates). It can be allergy, or soft growths (polyps) and sinus disease. Which one it is decides the answer: a spray used properly, an allergy plan, or an operation. The camera in the chair settles it in one visit.
What it looks like inside
What it usually is
The septum is the wall of cartilage and bone between the two sides of the nose. Almost everybody’s is a little bent. In some people it is bent enough to narrow one side, often since a childhood knock they have forgotten. The turbinates are shelves of tissue on the side walls that warm and filter the air. They swell with allergy, and with decongestant sprays used for too long. They also swell to fill the space on the wider side of a bent septum. Allergy swells the whole lining. Polyps are soft swellings of the sinus lining that grow into the nose. They are dealt with on the sinusitis page.
The commonest mistake with a blocked nose is operating on someone whose real problem was allergy. Just as common is years of sprays for someone whose septum was never going to move.
What happens at the first visit
After the history, at the hospital in KPHB, a thin camera is passed along the floor of the nose for about a minute. It shows the whole septum, both turbinates and the openings of the sinuses. A torch shows only the first two centimetres. Where the picture is allergic, allergy is assessed. Where sinus disease is suspected alongside, a CT is arranged. You leave knowing which of the four causes you have, and in what proportion.
What helps, and what is tried first
- A steroid nasal spray, used correctly, for six to eight weeks. Aimed along the floor of the nose towards the ear, not at the septum. You are shown how at the first visit, because most people have never been shown, and the difference is large.
- Saline rinses, which clear mucus and make the spray work better.
- Antihistamines and allergy avoidance, where allergy is part of the picture.
- Stopping decongestant sprays. Used for more than a few days they cause the swelling they relieve. Coming off them is itself a treatment.
Medicine first, properly and for long enough. For many people it is enough.
When to come in sooner
- A nose blocked on one side only, with bleeding or a bloodstained discharge
- A blocked nose with facial pain, fever, or swelling around the eye
- A blocked nose in a child that is affecting sleep or hearing
- A blocked nose after a recent injury, where the septum may need straightening early
If an operation is ever needed
Some noses are still blocked after a fair trial of medicine, and the camera shows a cause in the structure of the nose. For them, Dr. Santosh straightens the septum (septoplasty) and reduces the turbinates at Sinocare ENT Hospital. Both are one day procedures. Both are done entirely through the nostrils, with no change to the outside of the nose and no bruising. Where the nose is bent on the outside as well as blocked inside, both are corrected in one operation (septorhinoplasty). Each page below explains what is done, the recovery week by week, and what is watched for.
Questions patients ask
Do I have a deviated septum?
Probably, like most people. The question is whether it is the reason your nose is blocked, and the camera answers that.
Can sprays fix a bent septum?
No. Sprays treat the swelling of the lining. A bent septum is a problem of structure. That is why a fair trial of the spray is followed by a decision rather than another bottle.
Will surgery change how my nose looks?
Septoplasty and turbinate reduction do not. Only septorhinoplasty, which is planned as a separate conversation, changes the outside.
I have been using a decongestant spray every day for years. Is that a problem?
Yes, and it may be the whole problem. Bring the bottle. Coming off it, with help, is sometimes the treatment rather than an operation.
Is a blocked nose the same as DNS?
Not always. DNS, a deviated nasal septum, is one of the four causes. Swollen turbinates, allergy and polyps are the others. They are often combined, which is why the camera looks at all four.