What Is Nasal (Nose) Obstruction or Congestion?
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At Treasure Valley Nasal and Sinus Center, we pride ourselves on the time we take with our patients to learn about the exact nature and extent of their symptoms so that we can provide the most effective ENT treatment. As the founder of this ear, nose, and throat (ENT) clinic, Dr. Peter Killian is especially dedicated to providing thorough, consistent care to help bring relief in even the most stubborn of cases.

Various forms of nasal obstruction can drastically affect a person’s quality of life. If you find it difficult to breathe through your nose or you struggle with sleep apnea and snoring resulting in daytime fatigue, you may not realize the extent to which your life can improve once you are finally breathing easily.

The terms “nasal obstruction” and “nasal congestion” refer to the restricted or absent movement of air through the nasal passages. Many conditions and diseases cause these symptoms.

The most common causes of nasal and sinus congestion or obstruction fall under the following categories:

Sinus infections (also called rhinosinusitis or sinusitis) produce congestion or obstruction by causing inflammation or swelling of the nasal lining and by the overproduction of mucus as part of the immune response. While most acute sinusitis--like that caused by a virus (cold) or a bacteria--are treated by a primary care doctor or urgent care provider, chronic sinusitis may require the additional knowledge of an ear, nose, and throat (ENT) doctor to achieve and maintain relief.

Nasal allergies (also called allergic rhinitis) cause congestion and obstruction in much the same way as infection: through inflammation and through overproduction of mucus, causing a runny nose (rhinorrhea).

Structural abnormalities cause congestion and obstruction due to a physical blockage restricting airflow through the nose. Common examples of this are a deviated nasal septum, inferior turbinate hypertrophy, middle turbinate concha bullosa, tumors, or foreign bodies (most commonly seen in pediatric patients). The thin bone and cartilage partition dividing the nasal cavity into two halves is called the nasal septum. It is estimated that up to 80% of people have a deviated nasal septum, this can lead to nasal obstruction, nosebleeds, sinus infections, noisy breathing in children, and mouth breathing. Inferior turbinates are finger-like structures in the nose that are responsible for warming, moisturizing, and filtering the air that we breathe; when they become enlarged they can cause nasal obstruction.  Concha bullosa of the middle turbinate occurs when a pocket of air forms inside the turbinate enlarging its size creating nasal and sinus blockage.

Nasal polyps or sinus tumors Nasal polyps most frequently occur in the setting of chronic inflammation (chronic sinusitis), but the growth of the polyp means there is not just congestion from the swollen nasal and sinus lining but also obstruction from the physical presence of the polyp.


Treating Nasal Congestion & Obstruction With an ENT
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Dr. Killian and the staff at Treasure Valley Nasal and Sinus Center are diligent in offering a variety of treatments for nasal congestion and obstruction. We understand that a combination of medical (non-surgical) and surgical options may be required to provide you with maximum relief from your symptoms.
Not all nasal congestion requires a visit to the doctor, but you should see a doctor if:
  • Your child has told you they put something in their nose, or you saw them put something in their nose.
  • Your congestion symptoms are severe and persistent enough to keep you from regular activity.
  • You have noticeable discolored post-nasal drip (PND)
  • You have a persistent fever. (~100.4°F)
  • Your symptoms last 7-10 days or more.
  • You have persistent sinus pain or a sinus headache with your congestion.

If you are struggling with these symptoms and are looking to change your current ENT doctor or establish care with an ENT (also called an otolaryngologist), call Treasure Valley Nasal and Sinus Center at (208) 593-4484. We would love to help you start feeling better.

Once the source of your congestion is identified, Dr. Killian will work with you to discuss which treatment options are best for you. If your condition permits, non-surgical options are pursued first avoiding unnecessary surgery. Some of these non-surgical treatment choices include:
  • Antibiotic treatment for a bacterial sinus infection.
  • Corticosteroid (usually applied as an intranasal spray or with a saline rinse) treatment for chronic sinusitis and nasal polyps.
  • Antihistamines (oral and intranasal spray) for allergic rhinitis.
  • Ipratropium bromide for vasomotor, geriatric, and non-allergic rhinitis to reduce excessive mucus production and post-nasal drip. Vasomotor and non-allergic rhinitis does not depend on an allergic type reaction or IgE antibodies. This can occur due to certain medications, eating and drinking, weather or temperature changes, aging, hormonal changes or pregnancy, and alcohol consumption, particularly red wine. Geriatric rhinitis is similar but occurs in the elderly population and can cause constant nasal drainage, chronic need to clear the throat of mucus, nasal obstruction especially when lying down, nasal crusting, and decreased sense of smell.


Surgically Treating Sinus Congestion with an ENT Surgeon
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If non-surgical options are exhausted, or if the nature of the condition indicates, surgery may be a good choice. Dr. Killian completed an additional rhinology and anterior based skull fellowship after his residency to gain more experience and training in nasal and sinus surgery which makes him the most qualified sinus surgeon in Idaho and regionally. He is an excellent resource when you or your loved ones are considering surgical treatments for nasal and sinus obstruction, including:
  • Septoplasty, or surgical correction of a deviated nasal septum. Since a deviated septum can cause sleep apnea and/or snoring, septoplasty may be used as a surgery to stop snoring.
  • Turbinate reduction surgery. If your inferior turbinates have become chronically inflamed and enlarged, it may be beneficial to surgically reduce them for clearer breathing.
  • Sinus tumor removal surgery. Dr. Killian’s additional fellowship in rhinology makes him the most experienced and qualified sinus surgeon in the state of Idaho.
  • Functional Endoscopic Sinus Surgery. Also abbreviated as FESS, this refers to a surgical technique in which a small endoscopic camera is used to visualize the nasal passages and sinuses instead of having to make incisions on the face. This technique is used to enlarge the openings of the sinuses to facilitate normal mucus clearance, remove infection and inflamed tissue, and to make them available for topical delivery of medication. This technique is also used for removal of sinonasal polyps (also called a nasal polypectomy), sinonasal tumors, skull base tumors (pituitary tumors with neurosurgery), and cerebral spinal fluid leak repairs.
  • Balloon sinuplastyA small balloon is inserted into the sinus cavities through the nostril. The balloon is inflated enlarging the sinus ostia allowing for proper drainage of the sinus. The balloon is then removed, leaving a widened sinus drainage pathway.
  • Tonsil and adenoid removal surgery, or tonsillectomy and adenoidectomy, respectively. Tonsils and adenoids are both soft-tissue structures in the throat and back of the nose. They are usually part of the body’s defense against infections, but sometimes they may be chronically infected and need removal. Tonsillectomy and/or adenoidectomy are most often removed in children.

While many ENT surgeons consider their job done once the patient recovers from surgery, we take a more hands-on approach at Treasure Valley Nasal & Sinus Center. We believe that patients who have reached the point of surgery have done so because of chronic and severe symptoms that have failed medical therapy. We have proven that surgical outcomes are better for our patients when we are present and able to adjust our treatment techniques at every stage of their illness and recovery instead of merely stepping in for a surgical procedure. Long-term results improve significantly when we take this approach.

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Whether you’re just beginning the process of determining the cause of your sinus and nasal congestion, or you’re ready for the help of an expert with your known condition, Dr. Killian and the staff at Treasure Valley Nasal and Sinus Center are here to serve you. In and around Boise, Meridian, Eagle, Nampa, Kuna, and McCall Idaho, there is no one more qualified and willing to help. Call (208) 593-4484 or contact us today so you can start feeling better soon.  We serve patients from all of Southwest Idaho.
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