Nasal obstruction refers to poor airflow through the nose. There are multiple causes for nasal obstruction including nasal septal deviation, enlarged turbinates, nasal valve collapse and nasal/sinus polyps.
The most definitive way of diagnosing nasal obstruction is by an office-based nasal endoscopy. Watch a video of nasal endoscopy here. Using an aerosolized decongestant and anesthetic a rigid sinus telescope is used to evaluate the anatomy. Growths in the nose or sinus along with nasal septal deflection and turbinate size can be assessed. A variety of office-based techniques are now available to address nasal obstruction before proceeding to more aggressive surgeries in the operating room.
Nasal Septal Deviation and Enlarged Nasal Organ
The nasal septum is a bone and cartilaginous structure that separates the nose into a right and left side. Deviated septums are diagnosed in nearly 80% of adults. When the deviation results in significant breathing symptoms, a procedure may be recommended commonly referred to as septoplasty. A septoplasty procedure is done under general anesthesia in the operating room and involve internal incisions within the nose to correct deformity.
However, there are cases where a region of the septum, called the nasal organ, can be enlarged and can be addressed under a simple local office-based procedure using low heat energy. This is referred to as the VivAer® procedure.
VivAer® Nasal Airway Procedure
The VivAer® is a one-time non-invasive procedure that can be performed in minutes in our office. VivAer® Nasal Airway procedure uses a low-temperature process that gently reshapes tissue of the nasal airway to help you breathe easier right away. Patients typically return to normal activity on the same day.
Benefits of VivAer® Nasal Airway Procedure:
- Simple in-office procedure is completed using only local anesthetic
- Minimal discomfort, no incisions
- Lasting relief
- Clinically shown to significantly improve quality of life and provide long lasting relief
Hypertrophic turbinates are abnormally large structures that run along the bottom of the nose that filter, warm, and humidify the air as you breathe. In cases where our turbinate hypertrophy have not responded to maximal medical therapy, a number of procedures are available to reduce the size while still maintaining normal function.
Procedures that we perform and offer include turbinate submucous resection, cryotherapy, low-level heat energy ablation and very simple outfracture. Many of these procedures can be done in the office setting under simple local anesthesia with minimal discomfort, no incisions and limited downtime.
The nasal valve refers to the area where the lower nasal cartilage meets the inside of the nose at the septum. In certain patients, this cartilage is weak and floppy and collapses on itself which results in nasal obstruction. In certain patients, this cartilage is weak and floppy and collapses on itself which results in nasal obstruction. Many procedures are available to address this including Latera implants, low level heat energy (VivAer®) and more aggressive surgical techniques including stitching and cartilage implants. We have experience with all techniques and have helped to develop many of these technologies.
If the nasal obstruction is related to nasal/sinus polyps, a variety of medical options are first employed. The most exciting has been steroid implants that can be performed in the office setting under simple local anesthesia. Severe refractory cases that have failed surgery may be a candidate for a new biologic drug, Dupixent, which is clinically shown to dramatically reduce polyp size and growth. We were the first Midwest clinical site for the phase 3 trial three years ago. If all of these options fail, then computer guided endoscopic sinus surgery is a final option. It is a very common, safe and effective procedure that we have been performing for the past two decades. Your doctor will determine which option is best for you.