Nasal bone spurs are bony growths inside the nasal cavity that can cause discomfort and nasal issues. Many individuals have small spurs without symptoms, but these projections can occasionally narrow nasal passages. The presence of these spurs does not automatically necessitate their removal, as their impact on daily life varies significantly from person to person.
What Are Nasal Bone Spurs?
Nasal bone spurs are bony protrusions that develop within the nasal cavity, often from the nasal septum or turbinates. The nasal septum is the wall of cartilage and bone that divides the nose into two nostrils, while turbinates are structures that warm and humidify inhaled air. These spurs can vary in size, ranging from small, unnoticed growths to larger formations that significantly impede airflow.
Their formation results from the body’s response to localized irritation, repetitive stress, or trauma to the nasal bones. This includes injuries from contact sports, accidents, or chronic inflammation from allergies or sinus infections. Developmental factors can also play a role, as the septum may naturally develop an irregular shape during growth. When the nasal bone experiences ongoing pressure, excess bone material may be deposited, leading to these projections.
Nasal bone spurs can lead to several symptoms. Symptoms include persistent nasal obstruction, making breathing difficult through one or both nostrils, which can worsen when lying down. Headaches or facial pain may also occur, particularly if the spur presses against other nasal structures. Frequent nosebleeds can occur if the spur irritates the delicate nasal lining, and some people report a whistling sound during breathing due to turbulent airflow.
When Removal Becomes Necessary
The decision to remove a nasal bone spur is considered when symptoms become severe, persistent, and significantly impact a person’s quality of life, especially after conservative treatments have proven ineffective. A primary indication for removal is chronic nasal obstruction that does not respond to non-surgical interventions. Such obstruction can lead to difficulty breathing, mouth breathing, and a reduced sense of smell.
Recurrent and severe nosebleeds (epistaxis) directly attributed to the bone spur rubbing against the nasal lining may necessitate surgical intervention. Chronic sinusitis that persists due to the obstruction caused by a bone spur is a common reason for considering removal. The spur can block the natural drainage pathways of the sinuses, leading to recurrent infections.
Sleep disturbances, such as snoring or obstructive sleep apnea, can occur if a bone spur narrows the nasal airway, impairing airflow during sleep. Certain types of headaches, often described as pressure headaches or contact point headaches, may be caused by the spur pressing against the nasal lining or other structures. When these symptoms are debilitating and interfere with daily activities, surgical removal of the bone spur becomes a viable solution.
Non-Surgical Approaches
For individuals with mild to moderate symptoms caused by nasal bone spurs, non-surgical approaches are the initial course of action. These treatments aim to manage and alleviate symptoms rather than physically remove the bony growth. Nasal corticosteroids, available as sprays, can reduce inflammation in the nasal passages, easing congestion and improving airflow.
Decongestants, both oral and nasal sprays, can provide temporary relief by shrinking swollen nasal tissues. However, decongestant nasal sprays should be used cautiously and only for short periods to avoid rebound congestion. Saline rinses, using a neti pot or saline spray, help to flush out irritants, mucus, and allergens, keeping the nasal passages moist and clean.
Over-the-counter pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, manage discomfort or localized pain associated with the spurs. These medications reduce tenderness and inflammation but do not affect the spur itself. While these conservative methods can offer symptom relief, they cannot correct the physical obstruction caused by larger or strategically positioned bone spurs. If symptoms persist or worsen despite these measures, surgical options may be recommended.
Understanding the Surgical Process and Recovery
When surgical removal of a nasal bone spur is indicated, the procedure is performed using endoscopic techniques, involving a thin tube with a light and camera inserted into the nose. The specific type of surgery depends on the spur’s location and size. For spurs on the nasal septum, a septoplasty reshapes or removes portions of the septum to improve airflow. If the spur is on a turbinate, a turbinate reduction may be part of the procedure.
The surgery is done under general anesthesia as an outpatient procedure, allowing patients to go home the same day. During the surgery, an incision is made inside the nose, and the bony spur is carefully removed. The goal is to eliminate the obstruction and relieve pressure points within the nasal cavity.
Following surgery, patients can expect some discomfort, swelling, and nasal congestion, subsiding over one to three weeks. Nasal packing or splints may be placed inside the nose to support healing and reduce bleeding, though some surgeons opt not to use packing. Patients are advised to avoid strenuous activities, nose blowing, and heavy lifting for a few weeks. Regular saline rinses are recommended to keep the nasal passages clean and aid in healing, with full recovery taking several weeks to a few months.