Common nasal problems

The human nose is much more than a distinct facial feature. Your nose is the passage to many important structures such as the turbinates, septum, and sinuses. As one of the main components of the respiratory system, your nose plays an important role in filtering, moistening and warming air as you breathe in and out. Your nose contains special nerve cells that respond to odor molecules in the air. Once activated, these "olfactory" cells send signals to the brain, which controls your sense of smell. 

Research even shows that breathing through your nose can trigger a "relaxation response" inside your nervous system and may help you calm down, ease anxiety and improve focus.

It's not hard to imagine how problems with the nose can impact multiple aspects of your health and well-being. Here is information about six common nasal disorders or conditions. 

1. Allergic rhinitis

Allergic rhinitis, or hay fever, is an allergic reaction to substances in the air, such as pollen, mold, dust mites or pet dander. Allergic rhinitis can affect the way your nose feels and functions and lead to issues like a runny or stuffy nose, congestion, reduced or absent sense of smell (hyposmia/anosmia) and sneezing. 

To treat allergic rhinitis, a doctor can help you identify your specific allergy triggers (allergens) and help you learn how to avoid them. Your doctor may also prescribe medications to help alleviate symptoms, such as nasal steroid sprays, nasal antihistamine sprays, or antihistamines.

2. Nasal trauma 

Acute injuries affecting the nasal area can include:

• Nasal bone fractures
• Nosebleed (epistaxis)
• Nasal valve collapse
• Cuts, abrasions and burns involving the nose and face

Treatment depends on the type and severity of the nasal injury or infection, and can range from medication to reconstructive surgery. 

3. Deviated septum

The septum is a structure found inside your nose and is made up of bone and cartilage. Normally, the septum runs along the middle of your nose and separates your right and left nares (nostrils). A septum that is crooked or off-center, either from birth or after an injury, is called a deviated septum.

In some people, deviated septums can cause congestion and breathing problems. When symptomatic, deviated septums can be corrected with surgical procedures such as a septoplasty or a rhinoplasty (nose job). We often think of rhinoplasty as a cosmetic procedure, however this surgery is often done to improve breathing through the nose. 

4. Swollen turbinates

Turbinates are three pairs of structures inside the nose that help warm and humidify the air you breathe before it goes on to your lungs. 

Respiratory infections, allergens and airborne irritants like smoke can cause turbinates to swell, which can block the flow of air and make it difficult to breathe or smell.

5. Sinus infections

Sinus infections can range from acute to chronic. Acute sinus infections are most often viral, but can be bacterial and by definition, symptoms last less than 4 weeks. Regardless of type symptoms of acute sinusitis include discolored nasal drainage, congestion, decreased or absent sense of smell, discomfort in the cheeks, teeth, or around the eyes, fatigue, and possibly fever. Viral acute sinus infections run their course with symptomatic treatment. If a bacterial cause is suspected, antibiotics can be prescribed, but even bacterial infections are most commonly self-limited and resolve without treatment. The discussion of whether or not to take antibiotics should be held with your primary care physician. 

Chronic sinusitis is most commonly an inflammatory issue in which patients have symptoms of sinus infections that last at least 12 weeks or more. Often the prominent signs of a chronic sinus problem are nasal congestion and decreased smell and taste, however the other above-mentioned symptoms can be present as well. Simply stated, chronic sinusitis can be divided into chronic sinusitis with polyps or chronic sinusitis without polyps. 

Nasal polyps are non-cancerous growths found inside the sinuses and nasal passages.  Nasal polyps represent a form of chronic sinusitis in which there is an underlying issue with inflammation. Polyps can be associated with other diseases of inflammation include asthma and allergies, but this is not always the case. Rarely, polyps can represent an autoimmune disorder or genetic disorder such as cystic fibrosis. 

Polyps are painless, but they block airflow through the nose leading to congestion and decreased or absent sense of smell and taste. When polyps are severe, surgery is generally indicated, however this is just the first step in treatment. Ongoing medical management and close follow up with your surgeon is necessary to achieve the best outcome and reduce need for revision surgery.  

6. Sinonasal cancer

Numerous types of cancer such as squamous cell carcinoma, adenoid cystic carcinoma, sinonasal undifferentiated carcinoma, or nasopharyngeal carcinoma, can occur inside the nose and sinuses, although this is very rare. Symptoms of sinonasal cancers often initially present like other types of sinus disease and can be hard to identify in the early stages. 

Signs and symptoms of sinonasal cancer can include:

• Blocked nasal breathing or congestion
• Frequent sinus infections that don't get better with antibiotics
• Headaches
• Frequent nosebleeds
• Changes in eyes such as double vision or protrusion of one eye

It should be noted that these symptoms are quite common and rarely represent cancer. If you are concerned that you might have cancer in the sinuses, you should see an ear, nose, and throat surgeon as soon as possible. 

Do you have concerns about your nasal health? 

Visit siumed.org/doctor to schedule an appointment with an ear, nose and throat specialist or to learn more about our other health care providers who can address your specific nasal health concerns.