Chronic nasal obstruction, or a stuffy nose, is often caused by enlargement (hypertrophy) of the inferior nasal turbinates. Chronic nasal obstruction can impair normal breathing, forcing patients to breathe through the mouth and often affects their daily activities. Enlarged turbinates and nasal congestion can also contribute to headaches and sleep disorders such as snoring and obstructive sleep apnea, as the nasal airway is the normal breathing route during sleep.
There are various reasons for turbinate hypertrophy:
- Environmental irritants (such as cigarette or cigar smoke)
- Persistent sinus inflammation
- Aging process
- Congenital variations
- Pregnancy or other hormonal changes
It is common to have a nasal septal deviation in addition to inferior turbinate hypertrophy. Turbinates tend to be smaller on the side of the septal deviation and larger on the side opposite from the deviation. This makes sense because the body often tries to compensate for anatomic differences. When the septum deviates to one side of the nasal cavity, it takes up more space and the body adjusts by making the turbinates on that side smaller. In the other half of the nasal cavity, there is more space available and thus the turbinates there are larger. Deviation of the nasal septum and/or enlargement of turbinates are two of the main causes of nasal obstruction.
Allergy or irritant-related turbinate hypertrophy usually responds well to medical treatment. In treating the underlying cause, the turbinate swelling is often reduced and the problem is solved. Unfortunately, long-term chronic swelling can become irreversible and unresponsive to medical therapy. In these situations, turbinate reduction surgery may be required to help reduce the symptoms.