Assessment

Consider the following causes:

• rhinitis, sinusitis, polyps
• deviated nasal septum
• granulomatous conditions
• sino-nasal malignancy

Management

Treat rhinitis with a topical steroid spray. If confident that polyps are present, consider steroid drops or even short course oral prednisolone.

If there is unilateral obstruction and/or blood stained discharge, please send an urgent referral to ENT.

Consider routine referral to ENT if medical treatment fails.