Nasal Obstruction

Deviated Septum

The septum is made of bone and cartilage and is the dividing wall between the two nasal passages. Often times it can be deviated to one side or another causing unilateral obstruction or be S-shaped causing bilateral obstruction in patients. (see Figure 1) One may be born with these deviations or it can be acquired due to nasal trauma. Many patients realize the effects of chronic nasal obstruction in symptoms such as sinus headaches, recurrent sinus infections, significant snoring and sometimes obstructive sleep apnea. At the time of your initial consultation, Dr. Cohen will obtain a complete history of your symptoms and concerns, perform a through physical exam possibly with or without nasal endoscopy, review any CT scans or other images and arrive at a comprehensive treatment plan to address your concerns. If septoplasty is indicated then this procedure can be accomplished via a simple outpatient surgery with or without submucous resection of the turbinates.

Figure 1

Turbinate Enlargement/Hypertrophy

The turbinates are curved ridges along the sidewall of the nose on each side which are involved in humidification and filtration of the air we breathe in. These structures consist of thin bone covered by spongy mucous membranes that can get quite congested and enlarged at times with blood. There are 3 sets of turbinates on each side of the nose, termed the superior, middle and inferior turbinates. The inferior turbinates are responsible for nasal congestion as the nasal airflow is along the floor of the nose. (see Figure 1) The main cause of nasal congestion besides a deviated septum is inferior turbinate hypertrophy, although they are often seen simultaneously in symptomatic patients. Allergies are the main culprit for inferior turbinate hypertrophy. When patients are refractory to improvement in their nasal congestion with intranasal steroid sprays (i.e. Flonase, Nasonex, etc.) and/or antihistamines (i.e. Claritin, Zyrtec, Benadryl, etc.), then we can consider both in-office and outpatient surgical procedures to help resolve their nasal congestion. In-office options performed under local anesthesia include Coblation of the inferior turbinates. Outpatient surgical procedures include submucous resection of the turbinates. Dr. Cohen will obtain a complete history of your symptoms and concerns, perform a through physical exam possibly with or without nasal endoscopy, review any CT scans or other images and arrive at a comprehensive nasal and sinus treatment plan to address your concerns.

Figure 2