Why Can’t I Breathe Through My Nose?

In Michigan, many people suffer from difficulty breathing through their nose. Nasal obstruction, congestion, and a stuffy nose all have a similar meaning. Nasal obstruction causes can be varied. We will discuss some common causes and treatments for this problem.

Nasal Dryness

The colder months in Michigan often have low humidity levels, leading to dryness in the nose. Dryness on the inside of the nose leads crusts to form, and these can cause trouble breathing through your nose. In these cases, simple home remedies such as using a humidifier, saline nasal sprays, or nasal irrigation can help.

Nasal Allergies

One common reason for nasal obstruction is allergies. Allergies from pollen or other causes can make the inside of your nose swell, like when you bump your arm or leg, and it swells up. Swelling inside of the nose leads to congestion and difficulty breathing through the nose. Nasal allergies also can cause a runny nose, sneezing, itchy/irritated eyes, or sometimes swelling around the eyes.

Over the counter treatments can often be successful for mild nasal allergies. The best treatment for nasal allergies is to avoid the cause of allergies, but this is many times not possible. Other common treatments include nasal saline rinses and nasal saline sprays that help to wash allergens out of the nose. Nasal steroid sprays and allergy medications such as antihistamines can help to reduce inflammation and relieve trouble breathing.

Sinus Infections

Sinus infections are one of the most common causes of difficulty breathing through the nose. Viruses that cause the common cold usually cause sinus infections. Most viral sinus infections improve within 1-2 weeks. Bacterial infections less commonly cause them and may require antibiotics.

Sinus infections cause face pain, thick nose drainage, trouble smelling, and headaches. Your primary care physician can treat most sinus infections. However, if the infection does not improve, you may need to consult an ears, nose, and throat specialist. Chronic sinus infections may require a longer course of antibiotics, steroids, or sometimes sinus surgery.

Nasal Polyps

Some people develop outpouchings inside of their nose called nasal polyps. Nasal polyps typically look like a group of grapes and occupy space inside the nose leading to difficulty breathing. Patients with polyps often have a stuffy nose that won't go away, and they can't breathe through their nose for months (or years!).

An otolaryngologist (ear nose and throat doctor) can usually diagnose nasal polyps during a routine medical examination. For many years surgery was one of the only treatment options for nasal polyps. However, modern treatments include many non-surgical options in addition to outpatient surgeries.

Deviated Nasal Septum

The nasal septum is a wall in the nose made of cartilage and bone. A nasal septum that curves to one side of the nose can cause nose breathing problems. Nasal septal deviation can occur from injuries or sometimes because of the way the nose grows during childhood.

Often in these cases people will notice that it is hard to breathe through their nose all the time but there will be no mucous. People may also notice a constantly blocked nostril if the septum bows mainly toward one side. The congestion won't go away in these cases because the deviated nasal septum causes narrowing of the nasal cavity.

The long-term treatment for a deviated nasal septum usually is a surgery called a septoplasty. Septoplasty surgery can be safely and comfortably performed in an outpatient facility. Sometimes rhinoplasty and septoplasty surgeries are done together to fix nasal blockages and make the nose look better.

Nasal Valve Collapse

The nasal valve is the narrowest air passage of the nose. Nasal surgeons often think about the nose as an hourglass, and the nasal valve is the center body of the hourglass. The nasal valve has two main parts, and either one of those parts can have narrowing (nasal valve collapse or nasal valve stenosis).

Non-surgical treatment for nasal valve collapse includes nasal strips and over the counter devices. While these treatments can be effective for some, other patients do not like wearing anything on their nasal skin or in their nostrils. Procedural options for treating nasal valve collapse include a resorbable implant and surgical repair of the nasal valve cartilages.

Many nasal experts consider surgical repair of the nasal valve cartilages to be the most effective long-term option.  Nasal surgeons will often perform nasal valve repair surgery through a rhinoplasty approach.  You should see a doctor to evaluate this

Nasal Turbinate Swelling

Nasal turbinates (also called concha) are nose structures that help add humidity and warmth to air as we breathe in. These structures can swell in response to colds or allergies and cause blocked breathing. Sometimes these structures can grow too large during childhood and can similarly block breathing.

Treatment for nasal turbinate that are too large (called turbinate hypertrophy) often involves trying nasal steroid sprays. Nasal steroid sprays can help reduce inflammation in the turbinates and improve breathing. However, the medication unfortunately does not work for everyone. People who fail treatment with nasal steroid sprays may be a good candidate for a surgical procedure.

Turbinate reduction surgery is a surgery that aims to reduce the size of the turbinates. This is an outpatient procedure that is effective at reducing nasal obstruction related to large turbinates.

Conclusion

If you have a hard time breathing through your nose, consider seeing a surgeon who specializes in treating this condition.  Dr. Andrew W. Joseph is a facial plastic surgeon in Troy, Michigan who specializes in treating nasal obstruction and is an expert in cosmetic and functional nasal surgery.