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JAMA Otolaryngology Patient Page
March 26, 2020

Nasal Airway Obstruction Structure and Function

JAMA Otolaryngol Head Neck Surg. Published online March 26, 2020. doi:10.1001/jamaoto.2020.0165

What Is the Structure and Function of the Nose?

The structure of the nose is important for both the appearance of the face and nasal function. The nose and nasal passages are important for breathing, smelling, and for warming and filtering air.

Normal airflow through the nose should be unobstructed. When a blockage occurs, this obstructs airflow. Structural nasal blockage is most commonly caused by deviated cartilage and/or bone of the nasal septum, turbinate enlargement, or deformities of the cartilages around the nostrils. Structural issues can arise naturally or from trauma. Another reason for nasal obstruction is an inflammatory process that occurs in nasal mucosa (internal lining) of the nose. This inflammation can improve with topical or oral medications.

What Are Signs and Symptoms of Nasal Obstruction?

Nasal blockage presents with difficulty breathing through one or both sides of the nose. Symptoms can be constant or may be more noticeable when lying down. Often, nasal obstruction can affect the quality of sleep. The obstruction may lead to oral dryness owing to nighttime mouth breathing. The quality of nasal breathing can also be worsened during activity or exercise.

How Are Nasal Breathing Issues Diagnosed?

Nasal obstruction is diagnosed by careful clinical examination. This is performed by inspecting the nose on both the outside and inside. The nose is palpated to assess the strength and position of the nasal cartilages. A light is used to examine the inside of the nose for structural irregularities. The nasal valve is at the front part of the nose, and is the narrowest part of the nasal passage. Watching the way the nostrils move during normal and forceful breaths can help identify if there is narrowing or collapse of the nasal valve causing blockage.

How Is Nasal Obstruction Treated?

Medicated nasal sprays may be used to treat some nasal blockages. Often, to relieve nasal obstruction, outpatient surgery is performed to change the structure of the nose. These procedures include removing crooked cartilage or bone, reducing the turbinate tissues inside the nose, or strengthening the cartilages that support the nose and nostrils.

What Questions Should I Ask My Otolaryngologist?

  • What structural problems may be causing my nasal obstruction?

  • What measures can I take to improve the breathing through my nose?

  • Which procedures will best address my nasal valve blockage?

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Section Editor: Samantha Anne, MD, MS.
The JAMA Otolaryngology–Head & Neck Surgery Patient Page is a public service of JAMA Otolaryngology–Head & Neck Surgery. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Otolaryngology–Head & Neck Surgery suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, email reprints@jamanetwork.com.
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Article Information

Published Online: March 26, 2020. doi:10.1001/jamaoto.2020.0165

Conflicts of Interest: None reported.

Source: Barrett DM, Casanueva FJ, Cook TA. Management of the nasal valve. Facial Plast Clin North Am. 2016;24(3):219-234.

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