NASAL OBSTRUCTION

NASAL OBSTRUCTION can be temporary or permanent, intermittent or persistent, unilateral or bilateral 

PHYSIOLOGICAL 

CYCLIC:one nostril functions more than the other in cyclic phase in normal persons 

POSTURAL :While lying down on one side ,the nostril on the lower side gradually gets blocked ,while the upper nostril gradually opens due to naso –pulmonary  reflexes

REFLEX:If thenose is exposed to cold air ,the nose gets partially obstructed reflexly to provide better air 

Conditioning of the inhaled air and to warm it .Exposing the head and feel to chill or cold water also causes  reflex nasal obstruction

PATHOLOGICAL 

CONGENITAL:Chonal atresia and atresia of anterior nares may occur .congenital deviation of the nasal septum is uncommon

OBSTRUCTION :Deviated nasal septum is a common cause on the side opposite to the deviation ,compensatory hypertrophy of the turbinates may produce obstruction 

Adenoids in children are a common cause of mouth breathing 

TRAUMATIC :Birth trauma may deviate the septum ,but it is easily corrected by manipulating the nose External injuries  may cause fracture ,dislocation of the nasal septum or septal haematoma Foreign bodies obstructed the nose by their physical presence  and secondary infection.

INFECTION :All types of rhinitis and sinusitis causes obstruction .chronic hypertrophic rhinitis  With hypertrophic turbinates is a common cause of obstruction.common cold often produces temporary Obstruction  Septal abscess blocks the nose on both sides

NON INFLAMMATORY RHINITIS :Allergic rhinitis ,vasomotor  rhinitis 

MISCELLANEOUS :Nasal polyps,rhinitis medicamentosa

NEOPLASMS in the nose,paranasal sinuses and nasopharynx  produce unilateral nasal obstruction ,but later these may obstruct the other side also. Malignant neoplasms may be associated with blood stained discharge 

GENERAL CAUSES:Hypotensive drugs may produce nasal obstruction,hypothyroidism,using snuff ,smoking and alcoholism

COMMON CAUSES OF NASAL OBSTRUCTION 

IN CHILDREN:Adenoids,rhinitis and foreign bodies.

IN ADULT:Deviated  nasal septum,hypertrophic turbinates,nasal allergy or vasomotor rhinitis,polyps,sinusitis and rhinitis medicamentosa

IN ELDERLY:Hypotensive drugs,rhinitis medicamentosa ,malignancy in the nose,paranasal  sinuses

And nasopharynx should be ruled out if there is unilateral obstruction with blood stained discharge and sinusitis 

CAUSES OF UNILATERAL NASAL OBSTRUCTION

Congenital :choanal atresia 

Infections:sinusitis and rhinosporidiosis

Neoplasms

Miscellaneous :deviated nasal septum,hypertrophic inferior turbinate ,antrochonal polyp,foreign body , rhinolith and synechia.