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Why Blocked Nose And ENT Services
Your nose can get block at several points, from nostrils to the post-nasal space. Here at Singapore ENT Services, our team of doctors specializes in treating the following nasal conditions –
Alar Cartilage Collapse
As you breathe, a vacuum is generated in the nasal cavity. This pulls the soft alar cartilages inwards. The stiffness of the alar cartilage prevents collapse. If the alar cartilage is weak, the nose will block on inspiration.
What Can You Do About Weak Alar Cartilage
If the Alar Cartilage is weak, a batten can be used to stiffen it. Both the Alar Cartilages may need to be strengthened at the same time. The strengthening is done by creating a tunnel and inserting the
battens.
This picture shows the nose before the surgery. Did you notice the
– narrowing of the nostrils before the surgery, and also
– the thick septum and columella?
– The broad tip and
– the collapsing Alar Cartilage.
After surgery, the tips is more defined, nostrils are wider, and the Alar Cartilage is stiffer.
Pyriform Aperture Narrowing
The Pyriform aperture is surrounded by bone. In some people, the Pyriform aperture is smaller than usual. This narrowness causes the blockage.
Inferior Turbinates and Deviated Nasal Septum
The Inferior Turbinates can grow quite large due to bone or soft tissues abnormalities.
Large Inferior Turbinates may be caused by
– Soft tissues swelling such as allergy, infections or hormones
– Bone enlargement from structural factors
Swelling soft tissues respond well to medications. But bony enlargement does not respond to drugs, and surgery is needed.
Did you notice that this nasal septum is straight, and the middle turbinate is normal? Then it becomes enlarged and pneumatized – it is now filled with airs. The nasal spectrum is becoming more deviated to the right side.
Ethmoid and Maxillary Polyps
A polyp starts to form in the Ethmoid sinus. It slowly enlarged, being drawn by the force of gravity. It now obstructs the Maxillary sinus ostia, predisposing to sinusitis.
The polyp is located between the Middle Turbinate and the Inferior Turbinate. The polyp reaches the floor of the nose, causing complete nasal obstruction.
A polyp forms on the floor of the Maxillary sinus. It reaches towards the roof of the Maxillary sinus, and then reaches ostia. It erodes the bones around the ostia and escapes into the nasal cavity.
Just like the Ethmoid polyp, it is located between the Middle Turbinate and the Inferior 
Turbinate. Finally, it also reaches the floor of the nose.
An Ethmoid and Maxillary Polyps cannot be differentiated by Endoscopy. A CT scan is needed to make this distinction.
Adenoid Enlargement
The is the post-nasal space where the Adenoid enlargement occurs. An Adenoid enlargement is very common for children between the age of 3 to 10 years old.
Below is a plain x-ray showing mild Adenoid enlargement. Next to the picture you can see that the Adenoid enlargement is very enlarged and obstructive. The air-space is nearly completely obstructed. This child needs to have surgery to remove his Adenoids.
