Nasal breathing issues have multiple causes

Difficulty breathing through the nose is not always caused by a deviated septum, according to Marco Romeo, a plastic surgeon interviewed by the Spanish newspaper AS in October 2026. Other factors, such as the internal nasal valve, can also contribute to the problem.

The internal nasal valve is often overlooked

The internal nasal valve, located at the junction of cartilage and bone inside the nose, plays a significant role in determining how much air can enter the nasal passages. However, this area is frequently ignored in medical treatments, even when breathing difficulties are confirmed.

Public health system focuses on other nasal structures

In Spain, the public health system typically addresses the septum and nasal turbinates, which are bony structures covered in mucous membranes that help warm the air we breathe. These structures are more commonly treated than the internal nasal valve.

Narrowing of the nasal valve causes breathlessness

According to Romeo, a narrowing at the internal nasal valve can significantly reduce the amount of air entering the nasal passages, leading to a sensation of breathlessness, especially during physical exertion. This issue is often not addressed in public health care.