Post Traumatic Nasal Obstruction

Do not ignore the middle turbinate, for it may be a cause of nasal obstruction (Figure 7). In patients with a deviated septum, return of the septum to midline by way of septoplasty may actually diminish the airway on the side of a hypertrophied middle turbinate (Figure 8). Partial sacrifice of an enlarged turbinate, in this situation, may signifi­cantly contribute to improvement in nasal breathing.

The inferior turbinates can be hypertrophic, especially in a patient with allergic rhinitis. Medication can frequently be used to address this abnormality, but nasal obstruction resulting from inferior turbinate hypertrophy may persist.

Figure 13. A, This 52-year-old man complained of posttraumatic nasal obstruction, the left side worse than the right. B, Although nasal obstruction in patients with saddle-nose deformity commonly results from problems with the nasal valve, endoscopic examination in this patient revealed an additional cause: traumatic choanal stenosis, also seen here on CT.

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