This time of year is often marked with chronic congestion issues: stuffy nose, difficulty breathing, constant nose-blowing and perhaps even a sinus headache. It may be tempting to blame it on the high pollen count, but don’t discount the possibility that your congestion may be caused by something else.
The Structures of the Nose and Sinuses
Our nasal and sinus system comprises several passageways of cartilage and bone and is lined with tissue. Inside your nostrils, mucus (commonly called “snot”) keeps the skin hydrated and protected from scratches, as well as catches germs and other debris to prevent them from entering the body.
Above the nose and behind the face are the paranasal sinuses. These four paired pockets of air generate the mucus that lines the nostrils.
Your nasal system is closely connected to several other parts of your body, particularly your respiratory system, immune system and your ears and throat.
What Is Congestion?
It’s a common misconception that congestion happens because there’s too much snot in your nose, but that’s not true. Often, if you blow your nose when it’s stuffy, not much mucus comes out. Rather, that stuffed-up feeling comes from a blockage in the passageways, usually due to inflammation. When the tissues or blood vessels in and around the nose become swollen, they can impede your airways and block mucus from draining. This can also affect the air pressure inside your skull, as your sinuses are very sensitive to air pressure.
Possible Structural Causes of Congestion
As mentioned above, congestion is usually caused by inflammation, a common symptom of allergies, the common cold, sinus infections and other such maladies. Other times, there’s a structural abnormality or growth in your nasal system that’s impeding your airways. Here are some possibilities:
- Deviated septum. Your two nostrils are separated by a wall of cartilage called the septum. No one has a perfectly straight septum, but for some people, it’s crooked enough to significantly block the nasal passages.
- Enlarged turbinates. There are three turbinates on each side of the nose. These are small, curved, bony structures located near the septum. The lining of the turbinates is capable of swelling, and when that happens, it can obstruct the nose. Enlarged turbinates often occur at the same time as a deviated septum because they are so close together.
- Enlarged adenoids or tonsils. The adenoids and tonsils live at the back of the throat and act like filters to target and trap germs and prevent infection. However, they can sometimes become infected themselves, and when that happens, they may swell up and push against the nasal passages.
- Nasal polyps. Polyps are a benign (i.e., non-cancerous) growth, but that doesn’t mean that they’re harmless. When these small growths appear in the lining of the nasal passages, they can partially or fully block the airway.
- Tumor. A tumor will have the same effects on breathing and congestion as nasal polyps, but the cells are cancerous rather than benign.
- Choanal atresia. This is a congenital defect in which excess tissue in the nasal airway partially or completely blocks the airway, resulting in difficulty breathing.
- Saddle nose. This is a deformity in the shape of the nose where the bridge of the nose collapses inward, compressing the structures within the nose.
- Broken nose. Any injury or trauma to the nose can cause a bone or piece of cartilage to be moved out of place.
How an ENT Can Help
An ENT (ear, nose and throat), also called an otolaryngologist, is a specialist in conditions affecting the head and neck, particularly the ears, nose and throat system (as the acronym suggests). It is one of the most common healthcare specialties, and approximately 27 million people visit an ENT each year.
ENTs can treat all of the structural issues listed above. Many structural issues may require surgery—and otolaryngology is a surgical specialty—but some can be treated without surgery, depending on the severity.
If chronic congestion has been bothering you and you suspect that it might be a deeper issue than allergies or a viral infection, consider visiting an ENT specialist at Carolina Ear Nose & Throat – Sinus and Allergy Center for an evaluation of your nasal structures. It could be that the problem was under your nose the whole time.