Question: One day I had stuffed nose, cold it went away in couple days normal treatment. It was 18 months ago and since then my left nose hole when I look inside the walls are much more narrowed than the right one, I can breathe through the left nose hole 80 % less then before and has less smell senses. When I cover the right one, I can hardly breathe through the narrowed sinus passage of the left one alone. I visited general doctor and told him I am not sick (I mean no cold, mucus, headache) only dry left hole of my nose, he didn’t even look inside and gave me Nasonex, didn’t help.
Answer:
First of all, thanks for your question. Please realize that I can only offer general answers, which cannot replace your physician. Specific answers would require a full history and examination.
It is not uncommon for an upper respiratory tract infection to set off prolonged congestion. Quite frequently, unilateral congestion will be caused by an underlying narrowing of the passageway- such as from a “deviated nasal septum” that was not blocking enough to cause symptoms. Once one gets a little more swelling from a cold, you can get into a cycle of irritation and swelling, causing nasal obstruction (narrowed sinus passage), causing more irritation and swelling, etc.
Other times a cold can set off a low grade persistent sinus infection, which may present as one sided obstruction. Additionally, nasal polyps are swellings that can develop after a cold. Lastly, one can have other growths in the nose creating a narrowed sinus passage.
Antihistamines will work only for allergies and are not the recommended treatment for most of these problems. It really takes a good nasal evaluation, done in the office with a lighted telescope (or endoscope) to accurately determine what is causing your problems, and therefore how best to treat.
I hope this helps, but your problem should be able to be taken care of.
Robert Pincus MD
New York Sinus Center
Frequently Asked Questions
Prolonged unilateral nasal congestion after a cold can be caused by underlying issues such as a deviated nasal septum, persistent low-grade sinus infection, nasal polyps, or other growths inside the nose that narrow the nasal passage. These conditions may become symptomatic following upper respiratory infections due to increased swelling and irritation.
A deviated nasal septum occurs when the cartilage or bone dividing the nasal cavity is off-center, making one nasal passage narrower. This might not cause symptoms initially but can lead to obstruction after swelling from a cold or irritation, resulting in difficulty breathing through that side of the nose.
Nasal sprays like Nasonex, which are corticosteroids, are primarily effective for reducing inflammation due to allergies or nasal polyps. However, they might not improve nasal obstruction caused by structural problems such as a deviated septum or other growths. Proper diagnosis through nasal endoscopy is needed to guide the correct treatment.
A nasal endoscopy allows a doctor to visually examine the nasal passage and sinus openings using a lighted telescope. This thorough evaluation helps identify causes of nasal obstruction like polyps, infections, growths, or structural abnormalities, enabling the doctor to tailor the appropriate treatment plan.
Antihistamines are effective for nasal congestion caused by allergies but are generally not recommended for unilateral nasal obstruction resulting from infections, structural abnormalities, or nasal polyps. Treatment should be based on the specific underlying cause determined by a medical evaluation.
If you experience persistent nasal narrowing and reduced airflow in one nostril, it is important to have a comprehensive nasal evaluation by an ENT specialist. They may perform nasal endoscopy to diagnose the cause and suggest effective treatment options, which might include medical management or surgery depending on the diagnosis.
