Sinus and Nasal
Care
If your nose has been blocked for months rather than days, start here. Pick the line below that sounds most like you.
Which of these sounds most like your nose?
Four problems, four patterns. The pattern you have narrows the cause before anyone looks up your nose.
Sinus infections that keep coming back
Facial pressure, thick discharge, a dulled sense of smell, going on past 12 weeks.
A blocked nose, worst at night
Fine by day, shut once you lie down. Rinses and strips only take you so far.
One side always blocked
The same side, every day, for years. It never swaps. Structure, not swelling.
A nose that runs and drips all day
Clear drip, worse with cold air, strong smells, or the first bite of a meal.
Why does your nose block up when you lie down?
A nose that is fine all day and shut at night is not in your head. Three things change when you lie down.
The same nose twice, seen face on. Upright by day, then lying down.
- The septum. The wall of cartilage and bone dividing your nose in two. It does not move.
- A turbinate at rest. A shelf of tissue on the sidewall, slim now, so air moves past it.
- The same turbinate, swollen. Turbinates swell and shrink by design, one side at a time.
- The open side. While one side swells you breathe through the other and never notice.
- Drainage. It ran downhill all day. Lying flat, it sits still.
- Lying down, both sides swollen. Blood pools in the lining, so no open side is left.
Swelling is the part treatment can change. If it is the same side every night and it never swaps, read the deviated septum page instead.
Your options, from a rinse to an operation
Least invasive first. Each option is wrong for somebody, so that column is filled in on every row.
| Option | What it does | Where | Anesthetic | Recovery | Wrong for you if |
|---|---|---|---|---|---|
| Saline rinse, humidifier | Washes and moistens the lining | At home | None | None | You expect it to change structure. Mild and short lived. |
| Daily steroid spray | Reduces swelling in the lining | At home | None | None | The block is fixed structure. Brings nosebleeds, dryness, throat irritation, and you keep taking it. |
| Allergy testing, then drops or shots | Reduces allergic swelling over time | Office, then ongoing | None | None | You cannot commit three to five years. Aqueous drops are used off-label, which we say plainly. |
| Nasal strip or internal dilator | Holds the nasal valve open | At home | None | None | You want help while you are up and about. You wear it every night. |
| Turbinate reduction | Shrinks a swollen turbinate | In office | Local | Bleeding, crusting, dryness while it heals | The septum is the main block. Turbinates can swell again, and removing too much leaves a nose too dry. |
| VivAer, nasal valve treatment | Reshapes the nasal valve area | In office | Local | Two to six weeks of congestion and crusting | The septum is the main block, or you are under 22. Anthem calls it, CPT 30469, investigational. |
| Septoplasty | Straightens the septum itself | Operating room | General | Weeks, and worse before better | You have not treated swelling yet, or the valve or turbinates are the real problem. Risks are listed in full on the deviated septum page. |
In-office nasal valve treatment
VivAer reshapes the narrowest part of the airway. FDA cleared for adults 22 and over, which is not the same as risk free.
In-office sinus dilation
Balloon sinuplasty opens blocked sinus drainage paths without removing bone or tissue.
A nose that runs rather than blocks has its own in-office option, RhinAer. Anthem denies it under CPT 31242.
When is a blocked nose worth an ENT visit?
Most blocked noses are colds and settle on their own. These are the ones that do not.
Worth booking now
- Blocked for more than 12 weeks
- A daily steroid spray, used properly for two to four weeks, was not enough
- Mouth breathing at night, broken sleep, or a workout you cannot finish with your mouth shut
- Nasal strips help you, which says there is something specific to find
- You rely on a decongestant spray most days
- Sooner if one side is newly blocked, bleeds repeatedly, or it started after an injury
Not sure which cause you have? That is what the first visit answers.
Do you need a referral, and what will it cost?
Two questions people ask before they book.
A referral
Whether you need one is decided by your plan, not by us. Call and we will check your plan before you come in.
The cost
It is plan-specific. We verify your own benefits and put your number in writing before you agree to anything. Anthem lists VivAer, CPT 30469, as investigational and will not pay for it, and denies RhinAer under CPT 31242. Several options are HSA and FSA eligible if you self-pay.
Why have this looked at here?
One visit usually settles which cause you have. History first, then a look in the nose, a nasal endoscopy after a numbing spray, then a decongestant test that separates swelling from structure.
Two offices
Lawrenceville and Watkinsville, serving the Athens area.
In-office and operating room options
So what we recommend is not decided by the only thing we have.
We say when a procedure aims at the wrong target
If the septum is your problem, a valve treatment will not fix it.
Our clinics across Northeast Georgia.
Find the clinic closest to you and schedule a visit. Same-day appointments are often available.
What the research shows, and where it stops
What the studies actually measured. The third column is the part most pages leave out.
| What was studied | What it showed | What it does not show |
|---|---|---|
| Radiofrequency treatment of the nasal valve, VivAer | The American Academy of Otolaryngology (AAO-HNS) endorses radiofrequency treatment of the nasal valve. | Anthem and Blue Shield of California call it investigational. Its multi-year figures come from studies where everyone got the treatment, with nothing to compare against. |
| Turbinate reduction for a swollen turbinate | Shrinking an enlarged turbinate can improve a nose blocked by swelling. | Nothing about a deviated septum or a weak valve. Turbinates can swell again, and removing too much leaves a nose too dry. |
| Septoplasty for a deviated septum | A randomized trial compared septoplasty with non-surgical management and reported better quality of life scores in the surgery group at one year, holding at two years. | Which individual will get it, or what happens beyond two years. Some people find their breathing does not improve. |
Dr. David Dillard invented the ClearPath nasal balloon, is the named inventor on the patent, and is affiliated with Intuit Medical Products, the company that makes it. He also invented the VOAT procedure and is the named inventor on its patent. You should know that when you weigh his recommendation.
Anthem lists VivAer, CPT 30469, as investigational. Anthem denies RhinAer under CPT 31242.
Nothing on this page is medical advice. Individual results vary. Whether a treatment is right for you is decided at an in-person evaluation.
Find out which cause you have. Call (678) 689-1100, Monday to Friday, 8:00 AM to 5:00 PM, or request a visit in Lawrenceville or Watkinsville, serving the Athens area.
Ready to get this looked at?
Tell us what is going on and we will call you back to get you scheduled. Sleep and Sinus Centers of Georgia has offices in Lawrenceville and in Watkinsville, near Athens.