Dr. Nikhil Mali

Nasal congestion is the blockage of

the nasal passages usually due to membranes lining the nose becoming swollen from inflamed blood vessels It is also known as nasal blockage, nasal obstruction, blocked nose, stuffy nose, or stuffed up nose.

Nasal congestion can interfere with the ears, hearing, and speech development. Significant congestion may interfere with sleep, cause snoring, and can be associated with sleep apnea .

Nasal congestion can also cause mild facial and head pain , and a degree of discomfort.

Nasal blockage can be seen in the following Diseases

Common cold

The onset is acute, with a scratchy sore throat and cough. The nasal mucosa will appear red, boggy, and glassy. The nasal drainage will initially be clear but will later become colored (yellow-green).

Allergic rhinitis

Acute allergic rhinitis is often associated with eye irritation, paroyxms of sneezing, itching of the eyes, nose, or palate, and postnasal drip with cough. The nasal mucosa is bluishand pale. Seasonal rhinitis is usually caused by inhaled pollens. Perennial rhinitis is caused byallergy to animals, dust, mites, or mold.

Vasomotorrhinitis

Congestion is prominent, but rhinorrhea, sneezing, and itching are not. Rhinitis medicamentosa occurs after 3 to 4 days of continuous use of a topical vasoconstrictor.

There will be initial relief with its use that is then followed by rebound with worsened congestion.

Vasomotor rhinitis may also be precipitated by cold, emotion, or sexual arousal. The turbinates are red and boggy.

Nasalpolyp

Unilateral airflow will be obstructed and a polyp will be visible deep inside, beyond the turbinate, as a gray structure with the appearance of a skinned grape.

There is an associationbetween aspirin use, nasal polyps, and asthma, but the most common cause is chronic allergic rhinitis.

Sinusitis

Drainage, if present, will be purulent, although colored drainage can be found in otherconditions. There will be a sensation of facial fullness that worsens with bending forward, oftenaccompanied by fever and a headache .

On physical examination, there will be tenderness toconcussion and pressure, overlying warmth, and fever. The affected sinus will not transilluminate.

Drugs

Cocaine, beta-blockers, reserpine, and hydralazine can each cause nasal obstruction

Deviated septum

Deviation causes chronic unilateral obstruction, which is readily observed with a nasal speculum.

Intranasal foreign body

There will be nasal obstruction associated with a chronic unilateral mucopurulent discharge with a foul odour.

SarcoidosisSarcoidosis

presents with bilateral nasal congestion in as many as 20% of cases. Systemic symptoms such as fever, fatigue, or weight loss; pulmonary symptoms such as cough ordyspnea; or skin manifestations such as erythema nodosum or purple, waxy plaques are clues tothe underlying diagnosis.

Cerebrospinal fluid leak

Head trauma with a basilar skull fracture may go unrecognized.

Clear nasal drainage tests positive for glucose using a urine dipstick.

Wegener granulomatosis

Its earliest manifestation may be nasal obstruction, rhinorrhea, crusting,and chronic sinusitis with a fetid drainage. Development of a septal ulceration is present

Causes of Nasal blockage

o Allergic reaction o Common cold or influenza o Deviated septum o Hay fever , allergic reaction to pollen or grass o Reaction to medication (e.g. Flomax ) o Sinusitis or sinus infection

Treatment

The treatment of nasal congestion frequently depends on the underlying cause.

Both influenza and the common cold are self limiting conditions that improve with time; however, drugs such as acetaminophen (paracetamol) and ibuprofen may help with the discomfort.

A cause of nasal congestion may also be due to an allergic reaction caused by hay fever , so avoiding allergens is a common remedy if this becomes a confirmed diagnosis .

Antihistamines and decongestants can provide significant symptom relief although they do not cure hay fever.

Topical decongestants should only be used by patients for a maximum of 3 days in a row, because rebound congestion may occur in the form of rhinitis medicamentosa The use of nasal irrigation may help reduce nasal congestion. It involves rinsing the nasal cavity with salty water, however, this may cause further irritation.

Vaporisers

These are obtainable in ointment and oil form and have scented constituents that could assist in allaying a dripping nose or finding relief from the ‘stuffed or suffocated feeling’ by de-clogging the inflammation in the air passages.

Eucalyptus and oils like peppermint, menthol, camphor act on the nasal receptors, constrict the flow of blood and hence lower inflammation.

Menthol-based nasal strips

The placing of these strips is done below the nasal bridge for allaying obstruction as it lifts open the nostrils.

The menthol helps to relieve inflammation in the air passages.. Their strong-smelling nature helps to infiltrate the mucus obstruction, thus help to provisionally open the nasal passages.

Nasal Sprays

These sprays have decongestants like oxymetazoline or xylometazoline that contract the blood vessels. They additionally aid in stopping mucous formation

list of surgical procedures is shown below.

• Turbinectomy • Partial turbinectomy • Submucosal resection of the turbinates • Surface "scoring" techniques • Less invasive techniques

• "Hot poker" methods (electrocautery, radiofrequency, laser) • Powered/submucous inferior turbinoplasty • FESS (Functional Endoscopic Sinus Surgery) Septoplasty

According to Ayurveda

नासावरोध

नासाप्रतीनाह

Samprapti:

कफव्रुतो वायुरुदानसंद्यो यदा स्वमार्गे ववर्गुणः स्थितःस्यात्। घ्राणं व्रुणोतीव तदा स रोर्गो नासाप्रतीनाह इती प्रवदष्टः॥ सु .

उ .

२२ / १५



नासावरोध

 

मुखेन श्वसन



सकष्टश्वसन तालुशुष्कता Laxanas

Chikitsa

 स्नेहपान  वस्नग्ध धूम  वशरोबस्ि  स्नेहन  स्वेदनावद उपचार्

अपीनस

Samprapti: कफपरवरधदो न a सायां रुध्द्वा स्रोतांस्यपीनसम्। कुयाात्सघुघुार्ं श्वासं पीनसावधकवेदनम्॥

 नासावरोध ,  घुघुारं   श्वास , वपस्िल पीत पक्व स्राव

 स्नेहन ,  स्वेदन ,  वमन ,    ववरेचन , धूमपान , अवपीडन नस्य Chikitsa

नासाशोष

Samprapti:

शोषयेन्नावसकास्रोत्ः कफं च कुरुते अवनलः। शुकपुणाभनासात्वं .........

॥ वा .

सु . १९ / १६

Laxanas

 नासावरोध  नासाशुष्कता  सकष्टश्वसन ,  नासाववदारण  शुकपुणाभनासत्वं

 स्नेहपान ,  वस्नग्ध धूम  स्वेदनावद उपचार्

Chikitsa

पुटक

Samprapti:

वपत्तश्लेष्मावरुधः अतनाासायां शोषयेन्मरुत्। कफं सशुष्कपुटताम् प्राप्नोवत पुट्क्ं तु तत् ॥ वा . उ . १९ / २५

 पुटकोत्पवत्त  नासावरोध  नासाशुष्कता  सकष्टश्वसन

Laxanas

 स्नहपन   सनर्गध धूम प्रधमन नस्य  नाडीस्वेद

Chikitsa

नासाशा

Samprapti: दोषैस्िवभिैः प्रुिकश्च ब्रुयात्तिः अशाावस तिैव शोफाम्। सु .

उ .

२२ / १८

Laxanas

 नासावरोध   सकष्टश्वसन वशरःशूल  सानुनावसकउच्चार

Chikitsa

शिकमा

प्रवतश्याय

Samprapti: चयं र्गता मूधाावन मारुतादयः प्रुिकसमिाश्च तिैव शोवणतम्। प्रकोप्यमाणां ववववधैः प्रकोपणैन्रुणां प्रवतश्यायकरा भवस्ि वह॥ सु .

उ .

२४ / ४

 स्नेहन  स्वेदन  वमन  धूम  र्गण्डूष

Chikitsa

Dr. Nikhil Mali