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In order to understand what can cause a whistling nose, one first needs to understand why a nose may whistle. The nose is designed to direct air in a straight path towards the outside world into the lungs. The nose is your body’s first-line sensor for reporting the quality of the air back to the body. It will detect things like temperature, pH, humidity, and the presence of irritants. Additionally, it can serve as a first warning of danger, if the body detects dangerous environmental chemicals.
The body can then direct the nose to react accordingly. It can decrease the air’s temperature (if the air is too hot), or direct the nose to filter out irritant exposure (by increasing mucus production, or decreasing airflow rate). In order for the nose to properly work, air needs to go in a straight line from the back of the nose to the throat and airway. Any time that this airflow is interrupted, it can cause turbulent airflow that can lead to noises.
People may notice a whistling noise while breathing through their noses for various reasons. The most common cause of nasal whistling is a septal perforation. This is when a perforation or hole exists in the nasal septum, the cartilage that separates the left and the right nasal airflow tracts. As the air is pulled into the nose, instead of going straight to the back, the air can cross between each side, creating air turbulence and noises. In some cases, whistling sounds while breathing through the nose can also be caused by benign or cancerous growths in the nasal passage.
The most common cause of noisy breathing or whistling noises after a rhinoplasty is a nasal septal perforation. Oftentimes, septal cartilage is harvested during a rhinoplasty in order to restructure and shape the nose.. Inadvertent injury or excessive removal of cartilage or the internal lining of the nose can lead to a hole developing in the septum.
While this is quite rare, occurring in 1-3% of all rhinoplasties, you should be made aware of this risk prior to undergoing any nasal surgery. This is more likely to occur if your septum has a bony deviation known as a “septal spur.”
You may notice that your nose whistles more at night. This is normal, and can happen for many reasons. For one, you are likely less busy at night, and as your day winds down and you are less distracted, you may begin to notice the whistling noise more. Additionally, temperature and humidity changes in the evening also can lead to changes in the quality of the air, which may increase the relative turbulence of the air passage and cause the whistling to become more pronounced.
Treatment of a whistling nose will differ depending on the cause of the noise. The most common cause, septal perforation, can be treated non-surgically through the use of saline, ointments, and a humidifier. However, if the whistling persists then you may elect to place a “septal button.” This is a small button that plugs the hole, closing off the perforation. This can have some drawbacks, as the button can be prone to infections and most patients find it painful or uncomfortable. It is also cumbersome, as it needs to be exchanged often.
The final option is to close the hole through surgery. There are a wide range of surgical techniques available, and it’s important to discuss the benefits and alternatives of each in order to determine the best surgical option for you.