Blocked nose & chronic congestion

What can block the nose?

• The septum: a bend in the wall dividing the nose can reduce space on one or both sides.
• The turbinates: normal structures that warm and humidify air can enlarge with inflammation or have a substantial bony component.
• The nasal valves: narrow areas near the nostrils can be restricted or collapse during a breath.
• Inflammation: allergy and nonallergic rhinitis can swell the lining and vary through the day.
• Polyps or another growth: tissue in the nasal passage can obstruct airflow and needs examination.

The normal nasal cycle can make one side feel more open than the other at different times. Persistent, progressive or troublesome blockage deserves assessment, especially when one-sided or accompanied by bleeding.

The pattern helps locate the problem

Does one side stay blocked? Does it alternate? Is it worse lying down, during exercise or in allergy season? What changes with a spray? Dr. Fewins combines that history with an examination of the septum, turbinates and valves, using endoscopy when helpful.

Response to medication can offer a clue about swelling, but it does not by itself prove that surgery will help. Likewise, failure of one spray does not establish a structural diagnosis. CT is reserved for questions that need imaging.

Treatment follows the cause

Nasal steroid or antihistamine sprays and allergy management may help inflammatory congestion. A fixed septal deviation may need septoplasty if it contributes meaningfully to obstruction. Turbinate reduction can address tissue enlargement that remains troublesome despite appropriate care.

Polyps and sinus disease have their own treatment pathways. Nasal valve problems are assessed separately; straightening the septum alone may not address them. When several findings contribute, the plan should account for the combination.

Septoplasty · Turbinate reduction · Nasal polyps · Rhinitis treatment

Nighttime breathing, snoring and CPAP

Improving nasal airflow may make sleep more comfortable. For some people using CPAP, treating obstruction improves tolerance and may reduce the pressure needed. Snoring may improve, but the response varies.

Nasal surgery is not a dependable cure for obstructive sleep apnea, and it does not replace sleep evaluation or prescribed CPAP. Dr. Fewins addresses the nasal component and coordinates with sleep-medicine care. Primary snoring management is not a service offered here.

Know what you are trying to improve

The most useful conversation is specific: easier breathing on a particular side, less mouth breathing at night, better tolerance of exercise or CPAP. Dr. Fewins explains which findings he can change and which symptoms may still need medical management.

If you have already had a procedure and remain blocked, bring the operative report when possible. Revisiting the anatomy can show whether the original target and the current problem are the same.