Not all nasal congestion is due to inflammation. In some cases, inability to breathe through the nose is due to the growth of nasal polyps or tumors within the nasal cavities. This should especially be considered if occurring on only one side.
Nasal polyps are benign growths that arise in the sinuses and nasal cavities. If they grow large enough, they can obstruct nasal breathing. One third of polyps are associated with allergy and one third with chronic sinusitis. The etiology for the remaining third is unknown.
To diagnose an examination of the nasal cavities is necessary. A CAT scan of the sinuses is usually ordered to determine the extent of the disease.
The initial treatment of polyps may simply be the use of a nasal steroid spray. There is a condition in which some patients have polyps in association with asthma and sensitivity to aspirin and other non-steroidals. These patients must avoid aspirin and aspirin like products as well as certain foods.
Nasal polyps that do not respond to medical management can be surgically removed using minimally invasive endoscopic surgery.
Most nasal tumors are benign and can be surgically resected if needed. Malignant tumors of the nasal cavities and sinuses are rare. In either case, a biopsy will be necessary to determine the pathologic nature of the tumor which will in turn determine the proper treatment.