There are numerous causes of nasal obstruction and the underlying
cause must be determined in order to properly fix the problem. Dr.
Guida will need to take a careful medical history, perform a physical
examination of the nose and head and neck region, and often times
obtain a CT scan of the nose and paranasal sinuses to make an accurate
diagnosis.
The causes of nasal obstruction may be nonanatomic and due to conditions that cause the nasal lining to swell, meaning the cause has nothing to do with deformities of the cartilage or bony structures of the nasal framework. These causes can include chronic sinusitis, allergies, overuse of nasal sprays, use of birth control pills, a thyroid abnormality, or high blood pressure.
There are a variety of structural problems of the nose and head and neck which can also cause nasal obstruction. These include a deviated nasal septum, swollen turbinate tissue in the nose, nasal polyps, large adenoids, and even possibly a nasal foreign body. These can often be corrected surgically.
What is a deviated nasal septum?
The nasal septum is the partition that separates the right and left nasal cavities. It is made of cartilage and bone. Deviated or bent portions of the nasal septum can be caused by traumatic injuries to the nasal structures or due a congenital abnormality. When the septum is significantly deviated, it can block the nasal airway causing nasal obstruction. A deviated nasal septum can also block the outflow of the sinus passages, leading to chronic sinusitis.
I cannot breathe through my nose. Can that be fixed at the same time as making my nose look better?
Frequently, cosmetic nasal surgery is done simultaneously with functional nasal surgery. The most common functional complaint patients have regarding her nose is the fact that they cannot breathe through it. There are a variety of causes of nasal obstruction, some of them can be corrected surgically and some which cannot. Surgical problems that are easily corrected related to the nose include a deviated nasal septum, a fractured nasal septum, nasal polyps, or enlarged turbinates. Dr. Guida can determine the cause of the nasal obstruction by both a physical examination as well as a CT scan of the paranasal sinuses and nasal anatomy. This will give Dr. Guida detailed information and allow him to give you a clear assessment of your chances of improvement following surgery.
How does Dr. Guida fix a deviated nasal septum?
Fixing a deviated nasal septum involves one small incision inside the nose. Fixing this problem by itself does not cause any external bruising and there is no need for a nasal splint following the operation. Dr. Guida also does not pack the nose after the operation, as he uses a dissolvable suture to hold the structures in place afterwards. Typically, the patient can breathe well initially in the recovery room, but within several hours after the operation, the nasal lining swells and it will take approximately 1 to 2 weeks for the swelling to go away.
Can nasal polyps and chronic sinusitis be fixed surgically?
Nasal polyps are frequently associated with chronic sinusitis and allergic symptoms. Ideally, these are removed endoscopically under twilight anesthesia. It is best to get to the root of the problem and this usually involves removing not only the polyps but the disease tissue in the ethmoid and maxillary sinuses where the polyps originated. This will allow for much longer lasting result in a good possibility that the polyps and never recur.
My doctor told me I had swollen turbinates. Can this be fixed?
Turbinates typically enlarge over the years due to chronic sinusitis and or allergic symptoms. Some people are born with congenitally abnormally large inferior or middle turbinates. These are usually diagnosed on a CT scan prior to surgery. Dr. Guida prefers trimming these endoscopically under direct vision. Turbinates are essential for nasal humidification and filtration. Therefore, the turbinates should not be removed in their entirety but conservatively reduced in size. Again, this does not require postoperative nasal packing. There is postoperative nasal congestion which last for approximately 1 to 2 weeks.
How is the recovery after correction of nasal obstruction?
If Dr. Guida is only fixing the nasal obstruction and not simultaneously correcting a broken nose or performing cosmetic nose surgery, there should little to no bruising during the recovery phase. All the incisions and work are done inside the nose, so there are no visible scars. There is no need for an external splint during the recovery phase.
Though you may notice a significant improvement in the ability to breathe through your nose right after surgery, the inside nasal lining usually swells over the first several days after surgery, so the nose will feel quite congested. Dr. Guida will see you 5-7 days after surgery and at that time he will spray the nose with a decongestant and clean the inside of the nasal cavities, greatly improving the nasal breathing. It will take several more weeks for the congestion to go away completely.
Does Dr. Guida pack the nose after surgery?
No, Dr. Guida generally does not pack the nose after repair of the nasal obstruction. The inside incisions are closed with a dissolvable suture and there is generally no need for packing. This makes s the recovery much more comfortable and less painful.
Is the recovery for surgery on nasal obstruction painful?
Generally, the recovery is not painful, due to the lack of nasal packing. Most people complain more of nasal congestion, but not pain. It does ache and throb the first day or so after surgery. However, if the nose is accidentally bumped or hit early during the recovery phase, it will hurt for several minutes. Dr. Guida does prescribe a pain medication for after surgery which should be used, if needed.
