Blocked Nose

Are you suffering from Blocked Nose? Speak to us!

We'd like to help you understand more about "Blocked Nose in the Elderly". Online information collection, however, is not an effective way to ease this problem. Ensure you come to see the best ENT specialist.

Professor Havas is one of the few specialists who has post-fellowship training in this field. He is the Chairman of the Department of Otolaryngology Head and Neck Surgery at Prince of Wales and Sydney Hospitals. Please give us a call or use the booking form on the right to arrange an appointment to see him. You will be in capable hands.

Nasal Obstruction

Nasal obstruction is a common and important clinical problem. There are certain physiological changes that occur in the nose as an individual ages. The most important of these is the loss of static compliance or stiffness of the cartilaginous framework of the nose, particularly the upper and lower lateral cartilages. As these cartilages weaken with age several important structural changes occur in the nose:

  • The tip of the nose droops
  • The nostril collapses in
  • The nasal valve collapses with the negative pressure generated by a large inspiratory airflow.

The other major physiological change that occurs in the nose with ageing is alteration of the nasal cycle. The nasal cycle is a reciprocating cycle of congestion and decongestion that affects the erectile tissue located predominantly in the inferior turbinates and on the swell body at the front of the nasal septum.

The major neurological change associated with ageing is senile dysautonomia. The lining of the nose has a very complex secretory inervation of sympathetic and parasympathetic nerve fibres and with age an imbalance tends to occur with parasympathetic predominance. This is sometimes known as cholinergic rhinitis.


ENT Assessment for Blocked Nose

Physical examination: An Otolaryngologist will examine the nose functionally and anatomically.

Blocked NoseFunctional assessment involves assessment of nasal airflow and differential nasal airflow (nostril by nostril) before and after the application of mucosal sympathomimetic amines.

Anterior rhinoscopy involves examination of the nose with a nasal speculum. This allows for accurate assessment of nasal septal deviation, turbinate hypertrophy, mucous aggregation in the nose or the presence of any infection.

Nasendoscopy involves examination of the nose with a telescope. This provides clear magnified images of all of the vital structures in the nose and post nasal space and facilitates more sophisticated diagnosis of subtle nasal conditions.

Imaging is usually not required unless there is a history of, or clinical evidence of intercurrent rhinosinusitis.

In difficult cases, objective assessment of nasal airflow can be obtained using computerised active rhinomanometry. This allows for a very accurate assessment of total nasal airflow, nasal airflow nostril by nostril and a very accurate assessment of nasal airflow resistance.

Mucosal biopsies (plus or minus electronmicroscopy, for the diagnosis of mucocilial dyskinesia) are often performed as a research tool but are rarely used in clinical practice.


How to cure a Blocked Nose?

Senile dysautonomia is appropriately treated pharmacologically by topical application of anti cholinergic medication (provided there are no contra indications such as glaucoma or prostatic hypertrophy). Low grade allergic rhinitis does occur but is less common in the elderly and is appropriately managed by low dose surface acting minimally absorbed steroid sprays.

Mucocilial dyskinesia is difficult to treat because for normal hair cell function and mucous movement you need:

  1. normal plumbing in the nose
  2. normal hair cell function.

Anatomical problems in the nose are appropriately treated surgically. Contemporary surgical techniques are often endoscopic and minimally invasive so age is no contraindication to judicious surgical correction. Collapse of the nasal valve, either the internal valve or the external valve can be very successfully treated by autologous cartilaginous reinforcement. This can sometimes be done via an endonasal approach and sometimes requires a nasal decortication or external rhinoplasty approach.

Nasal septal deviations have significant effect on nasal airflow and hair cell function and can be corrected with minimally invasive Endoscopic Limited Septoplasty.

Recalcitrant hypertrophy of the inferior turbinates or septal swell bodies, are appropriately treated by minimally invasive endoscopic surgical techniques.