Why do I have nasal obstruction after surgery?

Question

Hi doctor,

I am a 22-year-old male with a longstanding history of chronic nasal obstruction and persistent breathing difficulties.

I have undergone two turbinate reduction procedures; however, I continue to experience significant symptoms, including:

A constant sensation of inadequate airflow through my nose.
Complete nasal blockage during physical activity or exercise.
Frequent need to breathe through my mouth, even while at rest.
A feeling that air enters my nose, but it does not seem to flow properly to my lungs.
Intermittent nasal dryness or thick mucus.
Ongoing throat discomfort, a raspy voice, and a sensation of blocked ears.

Although ENT specialists have not identified any clear structural abnormalities, and prior CT scans (performed several years ago) were inconclusive, my symptoms feel very real and significantly affect my quality of life.

I do not believe this is merely a subjective sensation. I genuinely struggle to breathe properly through my nose.

Could you please advise which diagnostic studies or evaluations might help identify the underlying cause?
Might a deviated septum or an undiagnosed allergy be contributing to these symptoms?
Would you recommend considering further surgical intervention?

Thank you very much for your time and guidance.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Your symptoms, which include persistent nasal obstruction that worsens with exercise, mouth breathing even at rest, the feeling that airflow is not properly reaching your lungs, intermittent dryness or thick mucus, and associated throat and ear discomfort, indicate that the problem may go beyond simple turbinate hypertrophy or an obvious structural abnormality.

Although past ear, nose, and throat (ENT) examinations and CT scans did not yield unambiguous results, it is prudent to seek updated diagnostic tests. A repeat nasal endoscopy and a high-resolution sinus CT scan may aid in the identification of minor structural factors, such as a deviated septum, nasal valve collapse, or concha bullosa. Nasal valve failure, in particular, can cause the sense of "disappearing" airflow, which is often exacerbated by deep or vigorous intake, such as during physical exertion.

A thorough allergy evaluation, including skin prick testing or serum IgE testing, may also be advantageous, because allergic or non-allergic rhinitis can produce chronic mucosal inflammation even in the absence of visible polyps. If you snore or have daytime weariness, a sleep study may help rule out sleep-disordered breathing.

If severe septal deviation or nasal valve collapse is detected, functional nasal surgery, such as septoplasty or nasal valve reconstruction, may provide more long-term relief. Meanwhile, conservative treatments including saline irrigation, antihistamines, and intranasal corticosteroid sprays may help relieve mucosal congestion and inflammation.

A full examination with an ENT expert who specializes in functional nasal airway issues would be the natural next step in determining the underlying cause and guiding suitable treatment.

I hope this addresses your concern.

Thank you.