Clinical assessment, diagnosis and management of nasal obstruction

Nasal obstruction is among the most common complaints to the general practitioner (GP). Causes can be divided into mucosal causes or anatomical abnormalities. Most mucosal pathologies can be managed effectively in the primary care setting, with referral to the otolaryngologist in cases that are resistant to medical therapy and in cases of structural anomaly. In cases of allergy, referral to an immunologist may be beneficial.

The aim of this article is to review the clinical assessment and management of nasal obstruction in the primary care setting. We consider the various causes of nasal obstruction, describe their management and define those cases that require specialist referral.

Nasal obstruction may be acute or chronic and is a manifestation of a wide range of disease processes, most of which are managed by the GP. In patients with persistent nasal obstruction and in those with structural abnormalities, specialist referral is warranted.