This next patient has two problems. She has a saddle nose deformity (also known as a “boxers nose” deformity) that is contributing to nasal obstruction and to an unpleasant nasal appearance. Many surgeons would simply assume that this was the cause of her nasal breathing problems – in fact two other surgeons she saw before me told her that!
Looking in her nose I with an endoscope, I suspected another problem and obtained a CT scan. Looking at this CT scan you can see that her inferior turbinates are small and her septum is straight – but she has two aerated middle turbinates (called concha bullosa) and these are crowding the nasal cavity and causing her nasal obstruction. By resecting the side portion of each concha bullosa, we make this space available for nasal breathing and significantly improve her nasal airway. We find this problem in a significant number of patients with nasal obstruction.