Are Narrow Nasal Passages a Cause for Concern? What to Know

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Are Narrow Nasal Passages a Cause for Concern? What to Know


Your nasal passages, which go from your nostril to the top of your throat behind your nose, are the part of your nose that helps you breathe in and out. If they are atypically narrow, they can lead to:

  • breathing difficulties
  • trouble sleeping
  • feeding complications in infants and children

There are many reasons you may experience narrow nasal passages, including:

  • genetics
  • aging
  • injury
  • an underlying health condition

There are a variety of treatments for narrow nasal passages.

You may experience several symptoms if you have narrow nasal passages. These can be similar in adults and children.

Newborns and infants breathe primarily through their nose, which can cause more noticeable symptoms if they have narrowed nasal passages or a nasal obstruction.

In adults

Signs of narrow nasal passages in adults include:

In babies and young children

Symptoms of narrow nasal passages in infants and young children may include:

Nasal obstruction may lead to your child having trouble with their ears, such as pain or discomfort, as well.

You may experience narrow nasal passages for many reasons. It may be due to genetics, aging, or injury. More specific underlying health conditions could also be the cause.

Your symptoms may also be signs of other causes of obstructive breathing, such as:

Genetics

Genetics may play a role in why you have narrow nasal passages. If other people in your family have them, you might, too.

Injury from trauma, burns, or surgery

Your nasal passages may become narrower due to a traumatic injury or burn, or even after nasal surgery, such as rhinoplasty.

One outcome is nasal valve collapse. Others are septal or nasal bone fracture or internal nasal scarring from prior surgery, packing, cautery, or nasogastric tube placement.

Underlying health conditions

Deviated septum

The septum is what divides your nasal passages into two halves. A deviated septum occurs when your septum is not divided evenly, and you breathe more air out of one side of your nose than the other side.

This is a common condition, caused by growth or trauma to the face. In fact, an estimated 80 percent of people have a deviated septum, according to the American Academy of Otolaryngology – Head and Neck Surgery.

Symptoms can include:

  • breathing difficulty
  • infections in your sinuses
  • nosebleeds
  • sleeping difficulty
  • snoring

Nasal valve collapse

A nasal valve collapse is a weakness or narrowing of the nasal valve, the narrowest part of the nasal airway. Any additional narrowing can further restrict airflow and can sometimes lead to the nasal airway becoming blocked entirely.

A nasal valve collapse is most commonly caused by nose surgery or by some sort of trauma to the nose. It’s more common in adults than in children.

Inferior turbinate hypertrophy

Nasal turbinates are long, narrow passageways that help warm and moisten the air that flows in through the nose. If the turbinates are too large, they can block airflow.

Inferior turbinate hypertrophy can also cause frequent infections and nosebleeds.

Nasal vestibular stenosis

This condition can occur when the vestibular lining of your nose becomes disrupted from injury or infection. It can vary in severity and affect one or both of your nasal passages.

A symptom of nasal vestibular stenosis is breathing difficulty in one or both nostrils.

Choanal atresia and choanal stenosis

This is a condition that occurs from birth, when the back of your nasal cavity is completely blocked (choanal atresia) on one or both sides or is narrowed (choanal stenosis). One in 7,000 newborns has choanal atresia.

Babies born with bilateral choanal atresia need immediate treatment because it is nearly impossible for them to breathe through their noses. However, an infant may not be diagnosed with unilateral choanal atresia right away if they can breathe through one side of their nose.

The conditions can occur on their own or as symptoms of a syndrome, such as CHARGE.

Symptoms include:

  • difficulty breathing
  • loud breathing
  • trouble feeding and swallowing
  • mouth breathing
  • respiratory distress

Babies with the condition exhibit cyclical respiratory distress that is self-relieved by crying.

This means that as mouth breathers, they go into distress every time they cannot eat and breathe at the same time (because they do not breathe through their nose). They then cry, which relieves the symptoms.

Pyriform aperture stenosis

This is a rare condition that occurs from birth. This happens when a newborn has a very narrow bony opening inside the soft tissue of the nose because their maxilla is overgrown. Severe symptoms include respiratory distress.

This condition is commonly associated with other conditions, like central megaincisor and holoprosencephaly, so imaging tests are needed to rule these out.

If you have narrow nasal passages, you may experience:

  • breathing difficulties, including the inability to breathe on one or both sides of your nose
  • trouble sleeping
  • nosebleeds
  • sleep disturbances
  • trouble eating (in infants and children)

Can narrow nasal passages cause sleep apnea?

Narrow nasal passages may lead to sleeping disturbances. One condition directly related to sleep problems is sleep apnea. This causes you to stop breathing for short periods of time throughout your sleep.

Having narrow nasal passages can play a role in developing sleep apnea, but other factors like large tonsils or adenoids (tissue at the back of the nose) in children and weight in adults play a bigger role.

A doctor will treat your narrow nasal passages based on your specific condition. Treatment goals may aim to widen, stabilize, or repair the part of the nose causing symptoms.

Specific conditions will require different treatments, including:

  • surgery to repair a part of the nose
  • surgery to insert stents or implants
  • dilation of your nasal passage
  • use of nasal spray or drops

Conditions that require certain treatments include:

  • Deviated septum. Treatment may include a surgery called septoplasty. This involves repositioning your septum so it restores the symmetry (evenness) in your nasal passages.
  • Nasal valve collapse. This is most commonly treated with surgery. People who want to avoid surgery can sometimes relieve their symptoms by using a nasal valve dilator.
  • Inferior turbinate hypertrophy. Over-the-counter and surgical treatments can treat turbinate hypertrophy.
  • Nasal vestibular stenosis. Your doctor may recommend stents in your nose.
  • Choanal atresia. Bilateral choanal atresia requires immediate surgery. Having the condition on one side (unilateral) may require surgery, but sometimes you may just need supplemental oxygen or saline spray or drops.
  • Pyriform aperture stenosis. Your child may require saline spray or drops or surgery depending on the severity of the condition.
  • Sleep apnea. Sleep apnea caused by narrow nasal passages can be treated with surgery that may include efforts to repair your septum, open your nasal passages, or widen your upper jaw.

Just because a condition is present does not mean it always needs treatment. Many people with mild septal deviations choose to not have treatment because they do not have discomfort.

When you experience nasal symptoms that interfere with your quality of life, like strenuous breathing or sleep disturbances, you should see a doctor. Begin with your primary care doctor, though they may refer you to an otolaryngologist (ENT doctor).

A doctor will conduct a physical exam using a nasal speculum or a small camera that they can insert through your nostril (nasal endoscopy). They may order tests like a CT scan to diagnose your condition.

You may have narrow nasal passages for several reasons, including genetics, injury, or a medical condition. Speak with a doctor if symptoms interfere with your daily life.



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