Q. I suffer from a blocked up nose nearly all year round and can never breathe easy through both nostrils. Instead I always breathe through my mouth which probably doesn't help my asthma. Also, I'm constantly being asked if I have a cold as the problem also affects the clarity of my speech. Is there anything that can be done for me and could surgery on my adenoids be the answer? If so, where would I have this performed and how much would the procedure cost?

A. Impaired breathing affects millions of people and can interfere greatly with everyday activities. Two general factors may be contributing to the problem and should be investigated: anatomy and physiology.

The anatomy of the breathing passages may require a visit to an E.N.T. specialist (ear, nose, and throat). Several conditions can contribute, including a deviated nasal septum, enlarged adenoid tissue in the back of the throat, and infected or inflamed sinuses, to name a few. The specific findings would determine what procedures might be beneficial. Many surgical advances have been made which allow mini-surgery techniques to accomplish a lot in this area.

The physiology refers to how your nose and sinuses react to the environment. As you have mentioned asthma, it is very likely that allergies are playing a role as well. Allergy treatment may involve medications such as antihistamines and cortisone nasal sprays, and allergy testing can lead to various measures to modify your environment to reduce symptoms. Home air filters and dust control measures are some examples in this area. Severe nasal allergies often benefit from allergy shots which make the immune system less reactive to those allergens in the air.

In many individuals, the anatomy and physiology both play a role and require treatment.

WEB REFERENCES:

http://www-surgery.ucsd.edu/ent/davidson/NASHAND/nasal.htm

http://www.theallergyreport.org/

http://www.aacfs.org/

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