The Way The Wind Blows

Question:  A 32 year old male is referred for chronic nasal obstruction.  He reports whistling with nasal breathing and excessive crusting necessitating frequent nasal rinses.  You examine his nasal cavities and find a 15 mm septal perforation and no static or dynamic evidence of nasal obstruction.  You are able to successfully close his perforation with rotational flaps from the septum.  Postoperatively, he is grateful and notes complete resolution of his nasal obstruction.  What is the etiology of nasal obstruction in this patient? [Answer will be posted with next week's new question]

Answer to last week's question, "Close Your Nose" (January 23, 2017)

Pharyngeal flap.