Dr. Shyam Kalyan. N
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
After waking up in the morning, there is eye area itching upto nostrils, running nose, light sneezing. Thus sleepy feeling and eyes weak feeling are there. I need tablets to not only sooth this condition but to prevent to occur it again.
Hello,
Welcome to icliniq.com.
As per your CT report you seem to have minimal thickening of mucosa which seems to be amenable to medical management (attachment removed to protect patint identity). However, we need the actual CT pictures to have an accurate assessment. Meanwhile, the steroid sprays and medicines are never going to act in one week. You need to take those for at least 2 months. Could you describe your symptoms further? Any headache? Any reduced sense of smell? Any endoscopy done? Did they suspect any polyps inside? Do you have nose block as well? Since when are your symptoms worse? Is there any seasonal predilection? Have you tried any antibiotics?
Patient's Query
Thank you doctor,
Medicines used for one week: Acef 500 mg, twice a day, Rega before food morning, Monzem tablet one at nights, nasal spray Furamist two puffs a day, tablet Nutrum mornings. All these for 7 days. Still not cured, symptoms returned right from the second day of finishing medicines. Symptoms are ther following only early morning to 11 AM, no symptoms in second half of the day. After waking up in the morning, eye area itching upto nostrils, which is causing to rub around the eyes, running nose, light sneezing. Thus sleepy feeling and eyes weak feeling. Need tablets to not only sooth this condition but to prevent to occur it again. Following are the answers to our questions: Could you describe your symptoms further? Any headache? No. Any reduced sense of smell? No. Any endoscopy done? No. Did they suspect any polyps inside? CT attached. Do you have nose block as well? No, only itching with running nose. Is there any seasonal predilection? I eat sprouts,, fruits, veggies, rice, ice-creams. Have you tried any antibiotics? Do not know. Drinking warm water often.
Hello,
Welcome back to icliniq.com.
As I can see from your CT films, you got some ethmoiditis and mucosal thickening of bilateral maxillary sinuses with some septal deviation (attachment removed to protect patient identity). The airway seems slightly blocked but that is not causing you symptoms of blockage. Now, your symptoms are worsened by the allergy. You must understand that allergy is something that is there in your blood and cannot be cured with medicines. It can only be controlled or kept to a minimum with careful precautions and timely medicines and sprays. Now talking of sprays and medicines for allergy, they are steroids. Do you suffer from diabetes or blood pressure? If not I would like to give you a short course of oral steroids. In any case I would like to put you on Fexofenadine 120 + Montelukast 10 daily in the mornings and Levocetirizine 5 in the evenings for 2 weeks and Fluticasone furoate nasal spray once daily every morning for 2 weeks. This would reduce the inflammation.I also want to institute a low dose Macrolide therapy which has proved to be really helpful for removing sinonasal inflammations to a good extent. You must also understand that there is some sinus component for the issue. You should try this treatment and then see for improvement. We may be able to offer you some relief with surgery, which is endoscopic sinus clearance and then spetum correction.Let me know what you feel. Also let me know if you have any medical conditions like diabetes or hypertension or arthritis or asthma or thyroid for which you are having to take medicines regularly.
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Otolaryngology (E.N.T)
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