Dr. Vinay. S. Bhat
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,
I have a complaint of nasal congestion. There is mucus discharge from the nose, or mucus drips down into the throat. I have had excessive mucus production since I was a child. I had a slight deviation of my nasal septum that was corrected through surgery. However, I still have these issues. I have taken corticosteroids for the same. Also, I consulted an ENT doctor, who did an endoscopy. The endoscopy did not show any nasal polyps. Kindly suggest.
Hello,
Welcome to icliniq.com.
I understand your concern and would be happy to help. A long-standing nasal discharge associated with a post nasal drip points towards either a nose allergy or chronic rhinosinusitis. A CT (computed tomography) scan of paranasal sinuses will help rule out chronic rhinosinusitis. Polyps can be diagnosed by endoscopy. To treat allergy, I suggest you use intra nasal steroids for long term. If a CT scan shows the presence of chronic rhinosinusitis, then a course of antibiotics combined with steroids and antihistamines will be effective. In certain situations, functional endoscopic sinus surgery may be the choice. I hope this helps. Kindly revert in case of further doubts. Thank you.
Patient's Query
Hello doctor,
Thank you for the response. I do not have allergies. How does a CT scan diagnose chronic rhinosinusitis? Also, the endoscopy tool was a straight metal instrument, which did not go very far up into my nose. Will it be able to view the maxillary sinus? Kindly suggest.
Hello,
Welcome back to icliniq.com.
A CT scan will show the presence of mucous or inflammation in the sinuses. An endoscopy can only visualize the mucous coming out of sinus openings. A symptom of polyps is mainly nasal obstruction. Nasal discharge and post-nasal drip are not the primary symptoms of polyps. I hope this helps. Kindly get back in case of further doubts. Thank you.
Patient's Query
Hello doctor,
Thank you for the answer. What are the signs of nasal obstruction? Kindly suggest.
Hello,
Welcome back to icliniq.com.
A nasal obstruction means a blocked nose. Persistent or intermittent nose blocks are the symptoms of nasal polyps. I hope this helps. Thank you.
Patient's Query
Hello doctor,
What are the indications of nasal obstruction? I have read on the internet about the symptoms of nasal obstruction that include nasal blockage, nasal congestion or stuffiness, trouble breathing through the nose, trouble sleeping, inability to breathe well during exercise or exertion, headaches, runny nose, post-nasal drip, facial pain, and pressure. Are the symptoms correct? Also, I am unable to breathe through my nose during any activity that requires heavy breathing. This is because even taking a slight deep breath through my nose causes a complete block of airflow, and the supra alar crease collapses, sealing it off. Kindly advise.
Hello,
Welcome back to icliniq.com.
There can be many causes of nasal obstruction. The symptoms of chronic rhinosinusitis include nasal obstruction, nasal congestion, post-nasal discharge, heaviness of the head, and facial pain. In the case of significant chronic rhinosinusitis, the intermittent nasal obstruction will be obvious during normal breathing, whereas mild chronic rhinosinusitis can have a stuffy nose during exertion. I hope this helps. Thank you.
Patient's Query
Hello doctor,
My surgery to correct a deviated nasal septum did not help much. I have a complete inability to breathe through my nose during exercise or exertion.
Hello,
Welcome back to icliniq.com.
An inability to breathe through the nose during exertion suggests a decreased airway space in the nose that cannot accommodate an increased air entry. Chronic rhinosinusitis, turbinate hypertrophy, or polyps can cause this. Since endoscopy has ruled out polyps and turbinate hypertrophy, chronic rhinosinusitis must be ruled out. A deviated septum was probably not the reason for your symptoms. I hope this helps. Thank you.
Patient's Query
Hello doctor,
Does an endoscopy not visualize the sinuses?
Hello,
Welcome back to icliniq.com.
Yes, an endoscopy cannot visualize the inside of a sinus. Polyps inside the sinuses do not cause any symptoms. Therefore, unless the polyps are big enough to be visualized outside the sinuses, they are not of any concern. I hope this helps. Thank you.
Patient's Query
Hello doctor,
Thank you for the answer. What is the best way to identify the cause of my problem?
Hello,
Welcome back to icliniq.com.
I suggest you go for a CT scan to identify the cause of your symptoms. I hope this helps. Thank you.
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Otolaryngology (E.N.T)
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