General Medical Information

Anatomic Nasal Obstruction

Shawn D. Newlands

Congestion, rhinorrhea, and nasal obstruction can be caused by acquired or congenital deformities of the nasal airway. Among neonates, choanal atresia is a cause of obstruction. Among older children and some adults, particularly those with human immunodeficiency virus disease, nasal obstruction can be caused by adenoid hypertrophy. Obstruction of the airway by septal deflection, turbinate enlargement, nasal neoplasia, or adenoidal hypertrophy alters nasal airflow and can block the normal pathway of nasal secretion; the result is irritation and rhinorrhea. Nasal polyposis occurs among 10% to 15% of patients with allergic rhinitis but is frequent without allergy. Polyps can be caused by chronic rhinosinusitis or cystic fibrosis or can be a part of Samter syndrome (asthma, nasal polyposis, and aspirin sensitivity). Polyps cause invariant nasal obstruction.