What causes of nasal obstruction?

Answer

Septal deviation

Turbinate hypertrophy

Rhinoplasty

Septal perforation

Valvular collapse

Choanal atresia

Neoplasm

Polyposis^[26]

Allergic rhinitis

Septal hematoma

Septal perforation

Rhinitis medicamentosa

Vasomotor rhinitis

Sinusitis^[27]

Mucosal vasodilation from pathogen-induced histamine release may cause allergic nasal obstruction. Inflammation and drainage from sinusitis may contribute to obstruction. Septal deviation is a common cause of obstruction. The relative size of turbinate hypertrophy is important because 50% of airflow is in the middle portion of the airway. Turbinates adjacent to a septal perforation may hypertrophy secondary to nasal airway turbulence, causing further airway resistance. Valvular collapse secondary to insufficient cartilaginous support may cause nasal obstruction. In addition, rhinoplasty may be the significant factor in iatrogenic nasal obstruction.

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Kerr A, ed. Rhinology. Scott-Brown’s Otolaryngology. 6th ed. Oxford: Butterworth-Heinemann; 1997.
Chen XB, Lee HP, Chong VF, Wang de Y. Numerical simulation of the effects of inferior turbinate surgery on nasal airway heating capacity. Am J Rhinol Allergy. 2010 Sep-Oct. 24 (5):e118-22. [Medline].
Li C, Jiang J, Kim K, et al. Nasal Structural and Aerodynamic Features that may Benefit Normal Olfactory Sensitivity. Chem Senses. 2018 Feb 21. [Medline].
Verhagen JV, Wesson DW, Netoff TI, White JA, Wachowiak M. Sniffing controls an adaptive filter of sensory input to the olfactory bulb. Nat Neurosci. 2007 May. 10 (5):631-9. [Medline].
Gudis D, Zhao KQ, Cohen NA. Acquired cilia dysfunction in chronic rhinosinusitis. Am J Rhinol Allergy. 2012 Jan-Feb. 26 (1):1-6. [Medline]. [Full Text].
Bailey B, ed. Nasal function and evaluation, nasal obstruction. Head and Neck Surgery: Otolaryngology. 2nd ed. New York, NY: Lippincott-Raven; 1998. 335-44, 376, 380-90.
Pendolino AL, Lund VJ, Nardello E, Ottaviano G. The nasal cycle: a comprehensive review. Rhinol Online. 2018. 1:67-76. [Full Text].
White DE, Bartley J, Nates RJ. Model demonstrates functional purpose of the nasal cycle. Biomed Eng Online. 2015 Apr 24. 14(1):38. [Medline]. [Full Text].
Cummings C. Otolaryngology: Head and Neck Surgery. St. Louis, Mo: Mosby Year-Book; 1999. 801-6, 816, 820.
Myers AD, ed. Biological Basis of Facial Plastic Surgery. New York, NY: Thieme Medical Publisher; 1993.
Eccles R. Nasal airflow in health and disease. Acta Otolaryngol. 2000 Aug. 120 (5):580-95. [Medline].
Cole P, Forsyth R, Haight JS. Effects of cold air and exercise on nasal patency. Ann Otol Rhinol Laryngol. 1983 Mar-Apr. 92(2 Pt 1):196-8. [Medline].
Silva EN. The Relation Between the Lower Lateral Cartilages and the Function of the External Nasal Valve. Aesthetic Plast Surg. 2019 Feb. 43 (1):175-83. [Medline].
Sasaki CT, Mann DG. Dilator naris function: a useful test of facial nerve integrity. Arch Otolaryngol. 1976 Jun. 102(6):365-7. [Medline].
Riechelmann H, Karow E, DiDio D, Kral F. External nasal valve collapse - a case-control and interventional study employing a novel internal nasal dilator (Nasanita). Rhinology. 2010 Jun. 48 (2):183-8. [Medline].
Rivron RP, Sanderson RJ. The voluntary control of nasal airway resistance. Rhinology. 1991 Sep. 29(3):181-4. [Medline].
Bachmann W, Legler U. Studies on the structure and function of the anterior section of the nose by means of luminal impressions. Acta Otolaryngol. 1972 May. 73(5):433-42. [Medline].
Tan M, Whitcroft KL, Mehta N, Schilder A, Leung TS, Andrews P. Investigating the Nasal Cycle Using Unilateral Peak Nasal Inspiratory Flow and Acoustic Rhinometry Minimal Cross-Sectional Area Measurements. Clin Otolaryngol. 2019 Feb 15. [Medline].
Kaura A, Pendolino AL, Navaratnam A, Andrews PJ, Leung TS. The Nasal Obstruction Balance Index: A Novel Approach to Improving Correlation Between Unilateral Nasal Airway Measurements and Evaluating Nasal Airway Asymmetry. Laryngoscope. 2021 May 5. [Medline]. [Full Text].
Lane AP. Nasal anatomy and physiology. Facial Plast Surg Clin North Am. 2004 Nov. 12 (4):387-95, v. [Medline].
Pless D, Keck T, Wiesmiller K, et al. Numerical simulation of air temperature and airflow patterns in the human nose during expiration. Clin Otolaryngol Allied Sci. 2004 Dec. 29 (6):642-7. [Medline].
Bridger GP, Proctor DF. Maximum nasal inspiratory flow and nasal resistance. Ann Otol Rhinol Laryngol. 1970 Jun. 79(3):481-8. [Medline].
Grymer LF, Hilberg O, Elbrond O, et al. Acoustic rhinometry: evaluation of the nasal cavity with septal deviations, before and after septoplasty. Laryngoscope. 1989 Nov. 99(11):1180-7. [Medline].
Grymer LF, Hilberg O, Pedersen OF, et al. Acoustic rhinometry: values from adults with subjective normal nasal patency. Rhinology. 1991 Mar. 29(1):35-47. [Medline].
Cakmak O, Coskun M, Celik H, Buyuklu F, Ozluoglu LN. Value of acoustic rhinometry for measuring nasal valve area. Laryngoscope. 2003 Feb. 113 (2):295-302. [Medline].
Nishijima H, Kondo K, Yamamoto T, et al. Influence of the location of nasal polyps on olfactory airflow and olfaction. Int Forum Allergy Rhinol. 2018 Feb 2. [Medline].
Battisti AS, Pangia J. Sinusitis. Hosp Pract. 2018 Jan. 14 (12):12. [Medline]. [Full Text].
Beekhuis GJ. Nasal obstruction after rhinoplasty: etiology, and techniques for correction. Laryngoscope. 1976 Apr. 86(4):540-8. [Medline].
Yu K, Kim A, Pearlman SJ. Functional and aesthetic concerns of patients seeking revision rhinoplasty. Arch Facial Plast Surg. 2010 Sep-Oct. 12 (5):291-7. [Medline]. [Full Text].
Parkes ML, Borowiecki B, Binder W. Functional sequelae of rhinoplasty. Ann Plast Surg. 1980 Feb. 4(2):116-20. [Medline].
Sachs ME. Post-rhinoplastic nasal obstruction. Otolaryngol Clin North Am. 1989 Apr. 22(2):319-32. [Medline].
Rohrich RJ, Ahmad J. A Practical Approach to Rhinoplasty. Plast Reconstr Surg. 2016 Apr. 137 (4):725e-46e. [Medline].
Helal MZ, El-Tarabishi M, Magdy Sabry S, Yassin A, Rabie A, Lin SJ. Effects of rhinoplasty on the internal nasal valve: a comparison between internal continuous and external perforating osteotomy. Ann Plast Surg. 2010 May. 64(5):649-57. [Medline].
Mojallal A, Ouyang D, Saint-Cyr M, Bui N, Brown SA, Rohrich RJ. Dorsal aesthetic lines in rhinoplasty: a quantitative outcome-based assessment of the component dorsal reduction technique. Plast Reconstr Surg. 2011 Jul. 128 (1):280-8. [Medline].
Tanna N, Nguyen KT, Ghavami A, et al. Evidence-Based Medicine: Current Practices in Rhinoplasty. Plast Reconstr Surg. 2018 Jan. 141 (1):137e-51e. [Medline].
Lee DC, Jin SG, Kim BY, et al. Does the Effect of Inferior Turbinate Outfracture Persist?. Plast Reconstr Surg. 2017 Feb. 139 (2):386e-91e. [Medline].
Moore M, Eccles R. Objective evidence for the efficacy of surgical management of the deviated septum as a treatment for chronic nasal obstruction: a systematic review. Clin Otolaryngol. 2011 Apr. 36 (2):106-13. [Medline].
Kim L, Papel ID. Spreader Grafts in Functional Rhinoplasty. Facial Plast Surg. 2016 Feb. 32 (1):29-35. [Medline].
Tardy ME. Rhinoplasty: The Art and the Science. Philadelphia, Pa: WB Saunders Co; 1997. Vol 2:
Kern EB. Surgery of the nasal valve. Session GA, Tardy ME Jr, eds. Plastic and Reconstructive Surgery of the Face and Neck. NY: Grune & Stratton; 1977. Vol 2:
Webster RC, Davidson TM, Smith RC. Curved lateral osteotomy for airway protection in rhinoplasty. Arch Otolaryngol. 1977 Aug. 103(8):454-8. [Medline].
Pontell J, Slavit DH, Kern EB. The role of outfracture in correcting post-rhinoplasty nasal obstruction. Ear Nose Throat J. 1998 Feb. 77(2):106-8, 111-2. [Medline].
Goudakos JK, Daskalakis D, Patel K. Revision Rhinoplasty: Retrospective Chart Review Analysis of Deformities and Surgical Maneuvers in Patients with Nasal Airway Obstruction-Five Years of Experience. Facial Plast Surg. 2017 Jun. 33 (3):334-8. [Medline].
Kasperbauer JL, Kern EB. Nasal valve physiology. Implications in nasal surgery. Otolaryngol Clin North Am. 1987 Nov. 20(4):699-719. [Medline].
Derin S, Sahan M, Deveer M, Erdogan S, Tetiker H, Koseoglu S. The Causes of Persistent and Recurrent Nasal Obstruction After Primary Septoplasty. J Craniofac Surg. 2016 Jun. 27 (4):828-30. [Medline].
Gerecci D, Casanueva FJ, Mace JC, et al. Nasal obstruction symptom evaluation (NOSE) score outcomes after septorhinoplasty. Laryngoscope. 2019 Apr. 129 (4):841-6. [Medline].
Yeung A, Hassouneh B, Kim DW. Outcome of Nasal Valve Obstruction After Functional and Aesthetic-Functional Rhinoplasty. JAMA Facial Plast Surg. 2016 Mar-Apr. 18 (2):128-34. [Medline]. [Full Text].
Floyd EM, Ho S, Patel P, Rosenfeld RM, Gordin E. Systematic Review and Meta-analysis of Studies Evaluating Functional Rhinoplasty Outcomes with the NOSE Score. Otolaryngol Head Neck Surg. 2017 May. 156 (5):809-15. [Medline].
Kocer U. Effect of aesthetic rhinoplasty on respiratory functions. Aesthetic Plast Surg. 2001 May-Jun. 25(3):202-6. [Medline].
Goode RL. Surgery of the incompetent nasal valve. Laryngoscope. 1985 May. 95(5):546-55. [Medline].
Broker BJ, Berman WE. Nasal valve obstruction complicating rhinoplasty: prevention and treatment. Part II. Ear Nose Throat J. 1997 Mar. 76(3):130-2. [Medline].
Beekhuis GJ. Nasal septoplasty. Otolaryngol Clin North Am. 1973 Oct. 6(3):693-710. [Medline].
Gungor AA. The aerodynamics of the sinonasal interface: the nose takes wing-a paradigm shift for our time. Int Forum Allergy Rhinol. 2013 Apr. 3(4):299-306. [Medline].
Li L, Han D, Zhang L, Li Y, Zang H, Wang T, et al. Aerodynamic investigation of the correlation between nasal septal deviation and chronic rhinosinusitis. Laryngoscope. 2012 Sep. 122(9):1915-9. [Medline].
Ozlugedik S, Nakiboglu G, Sert C, Elhan A, Tonuk E, Akyar S. Numerical study of the aerodynamic effects of septoplasty and partial lateral turbinectomy. Laryngoscope. 2008 Feb. 118(2):330-4. [Medline].

Media Gallery

(A) Laminar nasal airflow at a low inspiratory flow rate. (B) Turbulent nasal airflow at a higher inspiratory flow rate. Illustration by William E. Walsh, CMI; Northwestern University medical student and certified medical illustrator.
Anterior rhinomanometry. Illustration by William E. Walsh, CMI; Northwestern University medical student and certified medical illustrator.
Postnasal rhinomanometry. Illustration by William E. Walsh, CMI; Northwestern University medical student and certified medical illustrator.
Posterior rhinomanometry. Illustration by William E. Walsh, CMI; Northwestern University medical student and certified medical illustrator.

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Author

Samuel J Lin, MD Attending Surgeon, Plastic Surgery, Division of Otolaryngology-Head and Neck Surgery, Beth Israel Deaconess Medical Center, Associate Staff Physician, Otolaryngology, Division of Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School

Samuel J Lin, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, Triological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Daniel G Danahey, MD, PhD Consulting Staff, Department of Otolaryngology, DuPage Medical Group

Daniel G Danahey, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Cleft Palate-Craniofacial Association, American Academy of Otolaryngology-Head and Neck Surgery, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Dustin Crystal, BS Research Associate, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center

Dustin Crystal, BS is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Robert M Kellman, MD Professor and Chair, Department of Otolaryngology and Communication Sciences, State University of New York Upstate Medical University

Robert M Kellman, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Head and Neck Society, American Rhinologic Society, Triological Society, American Neurotology Society, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, Medical Society of the State of New York

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;Cliexa, eMedevents, Neosoma, MI10<br/>Received income in an amount equal to or greater than $250 from: , Cliexa;;Neosoma<br/> Received stock from RxRevu; Received ownership interest from Cerescan for consulting; for: Neosoma, eMedevents, MI10.

Additional Contributors

Daniel G Becker, MD Assistant Professor, Department of Otorhinolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Pennsylvania School of Medicine

Daniel G Becker, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons

Disclosure: Nothing to disclose.

What causes of nasal obstruction?

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