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Blocked nose but not got a cold? Mr Showkat Mirza answers common FAQs...


Mr Showkat Mirza, Consultant Ear, Nose & Throat (ENT) Surgeon
Claremont Clinics: Saturday AM
 
 
What are the causes of a blocked nose?
There are many causes.  The commonest include allergic rhinitis (nasal allergy including hayfever), a deviated nasal septum (a bent middle partition of the nose), nasal polyps (grape like swellings of the nasal lining), adenoids at the back of the nose, chronic rhinosinusitis and rarely tumours.
 
How is the nose examined?
The front of the nasal cavities can be examined with a nasal speculum and light or an auriscope (the instrument commonly used to examine the ears).  To look further into the nasal cavities, a nasendoscope is used. Commonly, the nose is sprayed first with anaesthetic and decongestant to make the examination easier for both examiner and patient.  Examination often, but not always, leads to a diagnosis.
 
What investigations may be performed?
Depending on the examination findings, further tests may be required including allergy testing for house dust mite, grass, cat and dog allergy and are usually a simple blood test.  Other blood tests may sometimes be required.  A CT scan of the nose and sinuses may be obtained to give further information on the nose anatomy and state of the sinuses.
 
How do you treat a blocked nose?
This depends on the cause.  Often medication may be tried, initially at least, including nasal wash sprays, steroid sprays/drops, antihistamines and even tablet steroids.  Depending on the condition, severity of symptoms and patient preference, sometimes surgery can be considered.
 
What is a Septoplasty operation?
This operation corrects a deviated nasal septum (a bent middle partition of the nose) and is usually performed under a general anaesthetic through the nostrils as a day-case.
 
How are nasal polyps removed?
This operation is usually performed under a general anaesthetic as a day-case and the nasal polyps are removed with a microdebrider, a thin device with a mouth at the end that effectively ‘gobbles’ up the polyps.  The sinuses may also be opened to effectively remove the ‘root’ of the polyps. 
 
What does sinus surgery entail?
Sinus surgery is usually performed with endoscopes through the nostrils, again under a general anaesthetic as a day-case.  The affected sinuses are opened with instruments including a microdebrider. Nasal packs are often used to minimise bleeding after surgery.
 
What is turbinate surgery?
The turbinates are normal swellings of the nasal lining in the nose and help warm up and humidify the air we breathe in.  In some conditions such as allergic rhinitis, they may swell up to the point they are blocking the nose and if this does not respond to medication, an option is to operate on them.  There are a number of techniques to reduce their bulk and make more space for breathing.  Patients may need ongoing medication to help with their underlying condition, for example, allergic rhinitis.
 
Is nasal surgery painful?
The pain following common nasal surgery procedures (as above) are usually minimal and relatively short-lived. Most patients go home the same day with simple painkillers.
 
What are the risks and complications?
The main complication of nasal surgery is a nosebleed but this is usually minimal and settles down. Rarely, patients need to go back to theatre for a nosebleed after surgery and depending on the type of surgery there are other risks and complications which are always fully explained to the patient prior to any procedure.
 
How much time will I have to take off work?
For most nasal operations it is recommended that 2 weeks are taken off, but this is variable and depends on a number of factors including patient fitness/motivation, type of work and extent of surgery.
 
A private consultation with Mr Mirza at Claremont costs £150 and a nasoendoscopy costs £200 if you don't have health insurance.  To book an appointment, call our friendly Private Patient Team on 0114 263 2114 or email privatepatients@claremont-hospital.co.uk.  You will need a referral letter from your GP or you can see one of our Private GPs quickly for this if you prefer.
 
Copyright Showkat Mirza, 2016.
 
Date: 16/08/2016
By: Laura Penn
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