Nasal airway obstruction,
a well-known cause of patient discomfort, is one of the most common presenting
complaints to the otolaryngologist. The different causes of nasal airway obstruction are very wide-ranging,
spanning from congenital life threatening causes to acquired benign
causes. Herein, we present a case of nasal obstruction caused by widening of
the posterior septum. A
52-year-old gentleman presented to the rhinology clinic with complaint of
chronic nasal congestion for 4 years. Trials of topical steroid sprays and
nasal saline rinses had been unsuccessful in symptoma- tic resolution. On anterior rhinoscopy, the septum
was noted to be straight anteriorly, but appeared to be deviated bilaterally,
flaring into the nasopharynx and obstructing the airway. A CT scan was
performed, which showed soft tissue enlargement on the posterior aspect of the
septum. The patient was subsequently taken to the operating room for a
posterior septectomy and inferior turbinectomy. He reported alleviation of
symptoms postoperatively. It is important for the otolaryngologist to be aware
of the myriad of causes of nasal airway obstruction. An accurate history and
physical examination including anterior and posterior rhinoscopy is important
in the diagnosis of nasal airway obstruction. More importantly, the physician
should be aware of the possibility of a widened posterior septum as a cause of
nasal airway obstruction.
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