The nose can be affected by a wide variety of conditions often resulting in a constellation of nasal symptoms including runny nose (rhinorrhea), nasal congestion or blockage, facial pain, headaches, nose bleeds, snoring and a post nasal drip.
Some common nose disorders include:
The nasal septum represents a wall of cartilage and bone that divides the nose into right and left. A deviated septum most commonly is a result of nasal trauma. Sometimes patients may not notice nasal blockage until decades after the trauma. Occasionally there is no history of facial trauma and it is postulated that the septal deviation may be caused by compression of the nose during childbirth. Often patients with a septal deviation complain of persistent but fluctuating nasal obstruction, which is often worse overnight, and during exercise. Septoplasty is an operation to straighten the nasal septum and improve airflow through the nasal passages. It’s nearly always performed in conjunction with surgery to reduce the turbinates to maximise nasal breathing improvement. The surgery is performed entirely through the nostrils and should not result in any facial swelling or bruising.
Sinusitis or Rhinosinusitis refers to the inflammation of the paranasal sinuses and is one of the most commonly diagnosed conditions in Australia. Both acute and chronic rhinosinusitis adversely affects patient’s quality of life.
Acute Rhinosinusitis represents a bacterial infection of the sinuses with nearly always occurs after a viral upper respiratory tract infection such as the common cold. Symptoms of acute rhino sinusitis include:
- Nasal congestion
- Facial pressure – especially when leaning forward,
- Yellow or green discharge from the nose and or post nasal drip
- Facial pain, nasal bridge discomfort or pain at the top of the head
- Bad breath
- Loss of smell
- Cough – especially at night
- Referred pain to the upper teeth
- A feeling of disequilibrium due to secondary eustachian tube dysfunction
Chronic Rhinosinusitis refers to inflammation of the sinuses that persists for longer than 3 months. The exact cause of Chronic Rhinosinusitis remains unknown and it’s thought to be caused by multiple factors including:
- Allergic Rhinitis (Hayfever)
- Possible immunodeficiency
- Nasal polyps
- A variety of anatomical factors in the nose that impede normal sinus drainage
Symptoms of Chronic Rhinosinusitis include:
- Nasal congestion or blockage
- Facial pain, fullness or pressure
- Mucopurulent runny nose or post nasal drip
- Chronic cough especially at night
- Reduced smell
- Referred pain the upper teeth
- Intermittent ear pain due to secondary Eustachian tube dysfunction
- Chronic Fatigue and/or Disequilibrium
Please see Dr Bova’s article, published in Medicine Today, on Adult Rhinosinusitis for further information.
The overwhelming majority of nasal polyps represent inflammatory polyps resulting from chronic allergic Rhinitis. It’s not understood why some patients with chronic allergies develop nasal polyps. These polyps represent localised swellings of the nasal lining, which gradually enlarge resulting in nasal obstruction. The polyps can also obstruct the paranasal sinuses leading to secondary chronic rhinosinusitis. Patients with nasal polyps often present with symptoms similar to chronic rhinosinusitis. For a detailed overview of nasal polyp management please see Dr Bova’s article, published in Medicine Today, on Adult Rhinosinusitis for further information.
Dr Bova’s article, published in Medicine Today, on Adult Rhinosinusitis: Download Article