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Houston ENT and Allergy Blog

Nasal Congestion/Blockage and The Vivaer Procedure in Houston Texas

By:
Tara Morrison, MD
April 26, 2019
Nasal Anatomy Animation - VIVAER_Aerin Medical - MKT516B (1)

Nasal congestion and blockage affect many people. There can be a number of causes of nasal blockage and it can affect your quality of life causing minor problems like a sore nose and dry mouth to more serious problems like trouble sleeping and problems hearing. If you're struggling with nasal congestion, don't hesitate to find out the cause and receive treatment.

What is Nasal Congestion and Blockage?

Nasal congestion is where your nasal passages are blocked typically due to inflamed blood vessels causing the membranes that line your nose to become swollen.

Nasal congestion occurs when your blood vessels and nasal and neighboring tissues become swollen with excess fluid which causes you to experience a "stuffy", plugged feeling. You may or may not have nasal discharge with the nasal congestion.

 

Problems With Poor Nasal Breathing

Nasal breathing is an essential function of life and experiencing any type of obstruction in your nasal airway that causes blockage or congestion in your nose can drastically impact your quality of life.

There are numerous causes for poor nasal breathing. Some individuals find it difficult to breathe when they come down with a cold. Others have problems breathing due to occasional bouts of acute sinusitis. This condition makes it hard to breathe through the nose for a week or more until the congested sinuses start draining and the inflammation subsides.

Your nasal passage is a pathway for allergens and viruses to enter your lungs. Therefore, your sinuses and nose are frequently linked with many lung disorders. Nasal passage or sinus inflammation can trigger reflexes causing an asthma attack. Allergies are the top trigger for asthma.

 

Some common nasal breathing problems are:

1. Sinusitis (Sinus inflammation)

When you have sinusitis, it means you have inflamed sinuses. Infection or another issue can cause sinusitis. Your sinuses are the hollow air spaces inside your bones that surround your nose. Your sinuses create mucus which drains into your nose. When your nose becomes swollen, it can block your sinuses, causing pain.

2. Nose and Sinus Damage

Trauma (injury) to your sinuses and nose can make it hard or near impossible to breathe through your nose. If you have a broken nose that doesn't heal properly it could lead to chronic nasal breathing problems. Facial bone and cartilage damage can block or impair your nasal airway.

3. Deviated Septum

Crookedness or another type of deformity of your tissue dividing the interior of your nose like a deviated septum can lead to issues breathing. A deviated septum can be present at birth (congenital) or can be caused by facial trauma.

If you have a malformation of the wall that divides the inside of your nose, it can significantly impair your breathing. You might have suffered facial injury or were born with the problem.

4. Nasal Valve Collapse (NVC)

When your nose tissues aren't formed properly or are weak, your nose can slightly collapse when you inhale, constricting air passage into your lungs. In some individuals, the nose's outer walls are thin and slightly collapse with each breath, constricting the airway and causing problems breathing.

Surgery or trauma to the nose can both lead to nasal valve collapse. But, you can suffer nasal valve collapse even without a history of surgery or trauma to your nose and it can actually be due to specific inherited anatomical characteristics. For instance, you could have narrow nostrils and an over-projecting nose or wide columella (this is the exterior section of the nose separating your two nostrils). You could also suffer a nasal valve collapse because of other congenital conditions.

You might have more risk of developing nasal valve collapse during your natural aging process which weakens the structures naturally that make up your nasal valve.

 

What a Nasal Valve is and its Role for Good Breathing

You have three structures just inside your nose that form a triangular area. This is your nasal valve. These structures are:

  • Your septum — the narrow ridge of tissue and bone between your nostrils.

  • Your lateral wall — the side tissue forming your nose's outer wall.

  • Your turbinates — the finger-shaped tissues that warm and direct air entering your nasal cavity.

If any part of your nasal valve becomes enlarged, it will reduce the size of your airway along with how much airflow you have, leading to nasal airway obstruction.

Your nasal valve is critical for the breathing competence of your nose.

Because your nasal valve area is the narrowest part of your nasal airway, it's a common area for nasal obstruction and nasal airway resistance.

 

Signs and Symptoms of an Enlarged Nasal Valve

Some nasal valve blockage symptoms include:

  • Nasal obstruction and blockage

  • Nasal stuffiness or congestion

  • Difficulty breathing through the nose

  • Snoring

  • Trouble sleeping

  • Crusting around your nostrils

  • Inability to get enough air through the nose with exertion or while you exercise

  • Nasal bleeding

Below are some different types of nasal valve treatment options.

 

Home Remedies for Nasal Congestion and Blockage

Some different home remedies for nasal blockage and congestion you may have tried are internal nasal dilators, sprays and external breathing strips. However, home remedies typically don't provide lasting symptom relief nor fix the problem.

However, when you're congested, you want to focus on keeping your sinuses and nasal passages moist. While individuals sometimes think you can clear a runny nose with dry air, it actually produces the exact opposite. When you dry out your membranes, it irritates them even further.

So, you want to keep them moist and to do this, you can:

  • Use a vaporizer or humidifier.

  • Drink plenty of fluids which will help thin your mucus out, preventing blocked sinuses.

  • Fill a pot up with warm (not hot) water and breathe in the steam or take a long shower.

  • Use a nasal spray which consists of salt water and helps prevent your nasal passages from becoming dried out.

  • Place a wet, warm towel on your face. It could open your nasal passages and relieve discomfort.

  • Try a nasal irrigator, Neti pot or bulb syringe. Use sterile, distilled water that you boiled and cooled for your irrigation solution.

  • At night, prop yourself up with a couple of pillows. When you elevate your head, it makes breathing easier and comfortable.

  • Don't swim in chlorinated pools since they can irritate your nasal passages.

 

Over-the-Counter Medications

There are some OTC medications you can take that could help relieve some of your symptoms.

1. Decongestants

These medications help reduce nasal passage swelling and ease sinus pressure and stuffiness. You can get them as nasal sprays such as oxymetazoline (Dristan, Afrin, Vicks Sinus Nasal Spray) or pill forms, such as pseudoephedrine (Sudafed) or phenylephrine (Sudafed PE).

2. Antihistamines

These include medicines such as Benadryl that help with runny nose or nasal discharge. If you use a medication that also has a decongestant, it will relieve your nasal congestion and stuffiness as well.

 

Surgical Treatment for Nasal Congestion and Blockage

Some types of nasal congestion and blockage surgery are:

Somnoplasty

Somnoplasty is a common procedure to help with nasal blockage and congestion. Somnoplasty involves a surgeon shrinking your turbinates to enlarge your nasal passages using radio frequency heat.

Balloon Sinuplasty

If the surgeon doesn't have to eliminate anything from your sinuses, you could be a good candidate for balloon sinuplasty. This is where the surgeon inserts a thin tube into your nose. A small balloon is attached at one end. They then guide this balloon to the blocked part in your nose and inflate it, helping to clear the passageway to drain your sinuses better and relieve your congestion.

Endoscopy

Another common procedure is endoscopy. The surgeon inserts very flexible and thin instruments into your nose called endoscopes. One has a small camera lens on it that sends images back to the computer screen so the doctor can see where the blockage is in your sinuses. The other removes scar tissue and polyps gently.

Nasal surgery involves pain, long recovery times and doesn't always provide perfect results. It's been the only advanced nasal problem treatment. While it can be effective, it doesn't always address the problem that causes nasal congestion from narrow nasal valves.

 

breathe-easily

The Vivaer Treatment Option to Repair the Nasal Valve

Millions of individuals struggle with nasal airway obstruction that limits their airflow through their nose. Your only treatment options, up until now, were breathing strips and medicine which provided only temporary relief and surgery which is painful, invasive and takes a long time to recover from. Today, however, there’s the Vivaer Airway Remodeling procedure your doctor can perform right in their office to help you breathe better.

The Vivaer treatment option:

  • Is non-invasive: It sends controlled energy to specific areas, reshaping your nasal airway effectively without damaging the tissue. With Vivaer, there's no removal or destruction to tissue, no cutting or incisions and no exterior change or implants.

  • Is an in-Office Procedure: Vivaer is an easy, in-office treatment option that integrates easily in the doctor's practice with very little workflow disruption.

  • Offers clinically proven results: Patients have experienced significant nasal airflow improvements and outcomes.

 

Here's what you can expect with the Vivaer procedure:

Pre-Procedure

Before your procedure, your doctor will sit down with you for a consultation and evaluation. They'll evaluate your nasal airway obstruction symptoms by performing the Cottles maneuver where they place a narrow tool inside your nose to lift the tissue in the nasal valve area gently and simulates the changes the Vivaer treatment may create. If this creates substantial nasal breathing improvement, you'll likely benefit from the Vivaer treatment.

Day of Your Procedure

The doctor will perform the procedure under local anesthesia. You might need someone to bring you to and from your appointment. There are no restrictions on diet before your treatment.

During Your Procedure

The doctor will numb up your nose in the inside first using a cotton ball soaked with a topical anesthetic. After several minutes, they'll remove the cotton balls and numb your nose further with a local anesthetic injection.

Then, they'll position the Vivaer stylus inside your nasal passage in the front and begin a treatment cycle lasting 18 seconds. They'll keep the stylus in place for an additional 12 seconds while the tissue being treated cools.

They'll then repeat the same steps, typically in three nearby locations in your nasal passage. They'll then repeat the procedure in your other nostril.

Post-Procedure

After your treatment, during your first few days, you might experience some tenderness and inflammation at the treatment area. If you have to blow your nose, be sure you blow it as gently as possible. Don't manipulate or pinch the treatment site. You might experience some crusting and congestion at the treatment area for the first few weeks after your procedure.

The doctor might recommend using a nasal rinse or spray or applying an ointment to the treatment site.

 

How to Determine if You’re a Good Candidate for the Vivaer Procedure

There are two easy tests you can take to determine if you're a good candidate for the Vivaer procedure: Cottle's Maneuver and Nose Score Test.

Cottle's Maneuver

You can perform a DIY Cottle's Maneuver at home to assess nasal congestion. Place a fingertip or two on your cheeks on the side of the nose and press gently and pull outward. This will open up your nasal valve temporarily. When you do this, if it helps you inhale through your nose more easily, your nasal congestion could be in your nasal valve and you'd likely be a good candidate for the Vivaer procedure.

N.O.S.E. Score Test

This test determines how severe your nasal congestion is.

N.O.S.E. Score Self-Assessment Test to Help Indicate a Narrow Nasal Valve

The Nasal Obstruction Symptom Evaluation (NOSE) test is a survey that assesses your breathing symptoms and how they affect your quality of life. It's an easy, validated survey with five questions that uses a 20-point scale for capturing the symptoms of your breathing. A higher score means your symptoms are more severe.

To start the test you:

Download this form and answer the five questions. You will rate the answers you provide from a range of 0 (isn't a problem) to 4 (severe problem). If you receive a 50 or higher score, you could be a good candidate for the Vivaer procedure.

Learn More Nasal Congestion/Blockage and The Vivaer Procedure in Houston, Texas 

Talk with our doctor at Houston ENT & Allergy Services about the Vivaer procedure to see if you may be a good candidate for the procedure. We’ll answer any questions you have about the procedure and give you more detailed information.

 

Learn More About The Vivaer Airway Remodeling Procedure!

 

 By, Tara Morrison, MD

 

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