Posted by: drkumaresh | February 22, 2010

Chronic Nasal Obstruction / Stuffy Nose

What are nasal Turbinates?
The nasal turbinates are small, shelf-like, bony structures covered by mucous membranes
(mucosa) that protrude into the nasal airway and help to warm, humidify and cleanse air as it
is inhaled and before it reaches the lungs. In patients with severe allergies or other problems,
the turbinates can swell to a large size, resulting in inability to breathe through the nose.

Chronic Nasal Obstruction and Enlarged Turbinates
Chronic nasal obstruction, or a stuffy nose, is most typically caused by enlargement of the
inferior nasal turbinates. The accompanying symptom of nasal obstruction affect people
throughout the day, as well as during sleep. A chronic stuffy nose can impair normal breathing,
forcing patients to breathe through the mouth and turn the simple acts of eating, drinking
and speaking into an annoying and sometimes painful experience.
Enlarged turbinates and nasal congestion can also contribute to headaches and sleep disorders
such as snoring and obstructive sleep apnea, as the nasal airway is the normal breathing route
during sleep. Once turbinate enlargement becomes chronic, it is irreversible except with surgical
intervention.

Causes
Chronic turbinate hypertrophy and nasal obstruction are commonly associated with rhinitis,
the inflammation of the mucous membranes of the nose. Common forms of rhinitis that can
cause enlarged turbinates and nasal congestion include allergic, vasomotor, irritative and
drug-induced. When the mucosa becomes inflamed, the blood vessels inside the membrane
swell and expand, causing the turbinates to become enlarged and obstruct the flow of air
through the nose.

Treatment
Medical management consists of:
Decongestants – shrink the blood vessels in the lining of the nose. These medicines only
relieve stuffiness, not a runny nose or other symptoms.
Antihistamines may reduce the amount of mucus.
• Saline nasal sprays to loosen thick mucous.
• Steam inhalation to Increase the humidity in the inspired air.
Congestion is often worse when you are lying down. Keep upright, or at least keep the head
elevated.

Surgical management:
Turbinectomy is a surgical procedure that opens up the nasal passages by removing/reducing
in size bone and soft tissue sponges. Turbinectomy may be performed in conjunction with
other nasal surgeries such as septoplasty or sinus surgery. The surgeon may remove bone only or bone and soft tissue. This may be achieved by cauterization, laser or microdebrider. Of these laser turbinoplasty provides much long lasting benefit.

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