Thank you for your query.
1. The most common cause for an obstructed nostril is a DNS (Deviated Nasal Septum
) and/or a Hypetrophied Inferior Turbinate. You have a history of nasal injury.
2. The nasal turbinates congest and de-congest alternately. This happens every two to seven hours in normal individuals, causing alternate nasal congestion
and blockage. This is known as the Nasal Cycle. This Nasal Cycle may get imbalanced.
3. This may also happen when you sleep on your side. However, it may also happen with autonomic nervous system imbalance and most importantly in case of DNS (Deviated Nasal Septum), even if it is mild.
4. On the concave side of the DNS, the turbinates hypertrophy asymmetrically. The middle turbinate may also develop into a concha bullosa
(large air cell). Also the color of the mucosa gives a clue for the diagnosis. For example, pale mucosa indicates longstanding allergy, reddish purple indicates acute allergy, reddish red indicates vasomotor or intrinsic rhinitis
as compared to normal moist pink healthy mucosa.
5. Usually, when the roomier nasal cavity is open and the narrower nasal activity is blocked, there is no feeling of nasal congestion. The opposite happens when the better side is blocked. Then both the nostrils feel blocked and the feeling of nasal congestion is experienced. Psychological problems, sleep disorders, fatigue, panic attacks are common and will decrease after treatment. Acid reflux may worsen the problem.
6. I usually recommend a trial with an antiallergic, antileukotriene and steam inhalation for 15 days. If there is good relief, medication is continued and tapered of over a few months. Do you have any other symptoms such as sneezing, headaches or rhinorrhea (nasal discharge)?
7. If there is no or poor response, I get a special plain CT Scan of the Paranasal Sinuses
(PNS) done pre- and post- decongestion with Otrivin nasal drops.
8. Turbinate reduction by Radio-Frequency Ablation or with Co-ablation is the latest surgical treatment
for hypertrophied turbinates with excellent results. Balloon Sinuplasty
is also a new option.