Nasal Obstruction

Nasal Obstruction & Congestion

There are a number of causes for a person’s inability to breathe through their nose. This issue affects toddlers to adults and often affects a person’s speech making them sound congested or nasally (also known as hyponasal speech). In severe cases, persistent mouth-breathing and even dental malocclusion may occur if chronic. Among the most common causes of nasal obstruction and congestion are:

  • Turbinate Hypertrophy
  • Deviated Septum
  • Allergies
  • Adenoid Hypertrophy
  • Nasal Polyps
  • Pregnancy (pregnancy rhinitis)
  • Nasal decongestant spray overuse/abuse (rhinitis medicamentosa)
  • Very narrow nose

Rarely, masses such as nasal polyps and even cancer may cause symptoms of nasal obstruction. As such, an initial important part of any examination investigating a person’s nasal obstruction is nasal endoscopy. Nasal endoscopy enables the physician to look into the back half of the nose which is not able to be seen by just looking into the nose with a flashlight. Beyond the examination, an exact description of a person’s complaints is helpful to determine what type of treatment whether medical or surgical would be most beneficial. The most common scenarios are described below:

If the patient is a child younger than 5 years old,

“I can’t breathe through my nose mainly one side.”

  • Answer: Deviated septum is most common cause. Treatment is surgical.


“I can’t breath through one side of my nose when I lay down on that side. When I turn, it opens up, but than the other side gets blocked up.”

  • Answer: Turbinate hypertrophy is the most common cause. Treatment is ideally surgical, though some medications such as steroid, atrovent, or antihistamine nasal sprays may be helpful.


“I can’t breath through my nose whenever I lay down. When I stand up, I can breath again.”

  • Answer: Turbinate hypertrophy is the most common cause. Treatment is ideally surgical, though some medications such as steroid, atrovent, or antihistamine nasal sprays may be helpful.


“I can’t breathe through either side very well all the time.”

  • Answer: Allergies, turbinate hypertrophy,deviated septum and/or adenoid hypertrophy may all be playing a role. Treatment depends on examination findings and may include medications and/or surgery. If this has been slowly getting worse with time, nasal polyps is something to check for. Rhinitis medicamentosa is possible if one has been using nasal decongestant sprays frequently.


“I can’t breathe through my nose only during the spring and fall.”

  • Answer: Well,allergies is the most common cause and treatment is predominantly through medications. Underlying turbinate hypertrophy or deviated septum may make the baseline symptoms worse.


“I have a cold right now and have terrible nasal congestion and can’t breath through my nose at all.”

  • Answer: In this scenario,turbinate hypertrophy along with generalized nasal mucosal lining swelling is the reason. Treatment really is time and medications to help with the symptoms until the cold passes. Rhinitis medicamentosais possible if one has been using nasal decongestant sprays frequently.


“I can’t breath through my nose very well and it has been slowly getting worse over time. I also have difficulty smelling and tasting foods.”

  • Answer: In this scenario,nasal polyps is likely, especially if allergies are also present. Rhinitis medicamentosa is possible if one has been using nasal decongestant sprays frequently.

“My nose is very narrow and when I try to breath in quickly, the sides of my nose collapse inward preventing me from breathing through my nose very well unless I inhale very slowly.”

  • Answer: In this scenario, the problem may be due to a narrow internal nasal valve. This surgery requires a functional rhinoplasty in which the narrow nose is widened.