When Nasal Sprays Aren’t Enough, Surgical Options for Chronic Blocked Nose
- mrtimbiggs4
- Nov 20
- 2 min read
Many people live for years with a constantly blocked nose. They try every over-the-counter spray, decongestant, or antihistamine, often rotating through different brands without lasting relief. But if your obstruction is caused by a structural problem, no amount of nasal sprays will solve it, because medication can’t move bone or cartilage.
At Adnova Clinic in Fareham, near Portsmouth and Winchester, I regularly see patients who have “tried everything” and are still congested. For most, the next step is a thorough assessment to see whether surgery, usually a functional septorhinoplasty, could restore normal airflow.
When Sprays Are (and Aren’t) Useful
For many patients, a steroid nasal spray such as mometasone, fluticasone or budesonide can reduce swelling inside the nose caused by allergy or inflammation. However, if there’s no improvement after a proper trial, one type of steroid spray, used correctly for three months, trying another brand rarely helps.
What matters is consistent use, not swapping between products. If a single, correctly used steroid spray hasn’t made a difference after three months, the problem is almost certainly more likely to be structural, not inflammatory. However, there could always be other issues at play, such as sinusitis or nasal polyps, so it's always worth getting a proper assessment.
Common Structural Causes of Chronic Blockage
Deviated septum – the wall dividing the nostrils leans to one side, narrowing the airway
Nasal valve collapse – the narrowest part of the nose weakens and collapses inward during breathing
Post-traumatic deformity – previous injury has displaced cartilage or bone
Turbinate enlargement – soft tissue ridges inside the nose are persistently swollen
Combined causes – many patients have more than one issue at the same time
These conditions limit airflow regardless of medication, so surgery is the only way to make a lasting difference.
Surgical Options
1️⃣ Septoplasty – Straightens the internal wall (septum) to open the nasal passage.
2️⃣ Functional Septorhinoplasty – Corrects both internal obstruction and external deformity in one operation.
Straightens the septum
Strengthens or widens the nasal valves
Improves nasal symmetry and structure
At Adnova Clinic, I perform this operation using Piezo ultrasonic and dorsal preservation techniques, reshaping the nasal framework with sound waves rather than force.
This allows:
Less bruising and swelling
No nasal packing (you breathe straight away)
More precise, natural results
Recovery and Results
Patients usually return to normal activity within 7–10 days. Breathing improvement is noticeable almost immediately and continues to settle over several months as swelling subsides.
For most people who have exhausted medical therapy, functional septorhinoplasty offers permanent relief from years of congestion and mouth breathing.
You can choose a convenient date for your surgery and unfortunately now, this type of surgery isn't available locally through the NHS. So privately funded treatment is the only surgical solution.
Summary
If you’ve already used one type of steroid nasal spray for three months without benefit, switching products is unlikely to help. It’s time to assess whether a structural cause is blocking your airway and whether surgical correction could finally let you breathe freely.
Consultations are available at Adnova Clinic, Fareham, with Mr Tim Biggs, Consultant ENT & Rhinology Surgeon.
To enquire or book an assessment:
📍 Adnova Clinic
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