Nasal Congestion

Here in Houston, most people will, at least at some point, experience nasal congestion. It is frustrating not to be able to breathe out of your nose and it can stop us from exercising and staying healthy.

Why is nasal breathing so important?

 The nose has many jobs.  One of the main jobs is moistening the air that you breathe.  Try this- for the next paragraph, make an effort to breathe only through your mouth- see what happens.  I can promise by the time you are done reading this, your mouth will be dry and you may even start to have a sore throat.  The mouth needs its moisture for food and doesn’t produce enough for you to spend long times breathing through it.  The nose is laid out perfectly to get the air the moisture it needs (as well as the warmth) so that the air doesn’t dry your throat and windpipe out on the way in.  The nose also is important for smell.  The truth is, smell is the main part of taste.  I love cooking, eating, and thinking about food all of the time- all of the time except for when I have nasal congestion.  I lose something important to me when I cannot breathe from my nose- the delicious tastes and flavors of my favorite dishes.  The nose has other important jobs- think about the smell of a harsh chemical.  Surprisingly, this is not really smell.  A totally different nerve than the normal smelling nerve carries the signal of dangerous chemicals to our brains.  This serves to protect us from breathing in or eating hazardous materials.  Nasal congestion prevents our body’s own defense mechanisms.

When do most people have nasal congestion?

For many people congestion is worse during certain times of the year, but others have difficulty breathing all year long.  Most patients that I see with constant congestion (many of whom have forgotten what it even feels like to breathe through their noses) are excited to do anything to help their problem.  For many people who just have congestion on again off again, they are ok with dealing with the discomfort.  But even congestion that just comes in one season or two can truly affect your life.  If you don’t feel well, you don’t function well.  Congestion can keep you from exercise, going the extra mile at work, and just enjoying the small things in your life.  Personally, I want to avoid all forms of nasal congestion at all times because I have other, more important things to worry about.

What causes nasal congestion?

There are 4 factors that affect nasal breathing.

1. The lining of the nose. This is greatly affected by allergens, molds, and pollutants, all which run rampant in Houston.  If these irritants touch the lining of the nose, which you cannot avoid easily, they will lead to lots of swelling.  A swollen nose leaves little room for air.  Then the nose can’t do its job of moistening and smelling and you end up uncomfortably breathing through your mouth.  Treatments to decrease the swelling of the lining include medications for allergies, topical nasal sprays and even allergy testing with allergy shots/drops.
2. The nasal septum. This is the structure that divides the nose into left and right sides.  If the septum is not straight, it can obstruct the flow of air through the nose.  Think of a wall dividing two rooms- if the wall is crooked, one room will end up being smaller than the other.  Equality is extremely important in the nose- you will feel even small differences in space from one side to the other.  The only way to fix this problem is with a procedure to “straighten the wall.”  This involves removing the cartilage or bone that is pushing the septum to one side or the other.  It is a common procedure and usually has great outcomes.
3. The nasal turbinates. These are the structures on the side of the nasal cavity that act as the radiators of the nose. They are made of bones covered in reactive nasal lining. If they are too big, they lead to extreme susceptibility to nasal congestion from allergens, molds or pollutants.  It makes sense- think of a size 10 shoe box.  You put a size 10 ½ pair of shoes in the box barely squeezing them inside.  Now you try to make room for tissue paper and a pair of socks- this will be difficult.  If you start with a size 6 shoe in the box instead of a 10 ½, all the extras will fit without problem.  The nose is the same- if you have big bones in your nose, any swelling of the tissue will lead to complete obstruction.  If your bones are smaller, the same amount of swelling won’t cause any problems.  We can reduce the size of the bone with a simple long-lasting procedure that can frequently be done in the office.
4. The nasal sidewalls. Sometimes the structures inside the nose are not the main cause of obstruction. If the sides of the nose are not strong enough to resist the tendency to collapse then the nose will obstruct when you breath in. If you look in the mirror and see the sides of your nose moving inward as you breath in…you may have “nasal valve stenosis”. One way to confirm this is to place your forefingers on either side of your nostrils and pull outward. If this causes an improvement in breathing, you may qualify for help with your breathing. We can help to strengthen the sidewalls by the use of implants and/or a nasal reconstruction with cartilage grafts depending on how you nose is shaped.

Is there any good news?

The great thing about nasal congestion is that we can fix the problem.  Whether through a simple medication, or through a surgery to completely correct the problem, you have hope.  Septoplasties and turbinate reductions have incredible success rates and are simple to perform and undergo.  Nasal congestion needs to be one thing that you cross off your worry list.  Don’t keep hoping that you won’t get it as badly next year or wait for the season to pass.  Enjoy today.  Breathe easy.

And remember, your nasal congestion may not just be nasal congestion.  You may also be experiencing chronic or recurrent sinus infections and just put all the blame on your nose. The sinuses are a little different than nasal breathing but are closely related. In a separate post, I’ll talk more about why we get sinus infections and what to do about it.  But for now, this is something to talk to one of us about and see if you would benefit from a deeper look into your sinuses.  The moral of this blog post is simple: don’t suffer from nasal congestion.  Texas Sinus & Snoring can help!