Q. I have sinusitis with polyp in right maxillary sinus. Please help.

Hi,

Welcome to icliniq.com.

We have to first ascertain as to why sinusitis has occurred in the first place. Usually, in most cases, the primary cause is a seasonal or year around allergic problem that is there. Just to make you understand I have tried to explain things in a simple way below. Exposure to dust (or any irritative substance that your body is hypersensitive to) will initially initiate reflexes such as sneezing to remove the offending agent out but if this fails, mucosal cells in you nose start to hyperfunction producing loads of mucus to trap dust (owing to its sticky nature), this mucus has no where to go other than either being blown out of due to mucociliary activity gets pushed into the throat, thereby entering into a new zone. The throat initially reacts by activating cough impulses to push out the mucus, but if that fails, a local inflammation around the throat starts which often leads to symptoms such as feeling of a lump in the throat and repeated feeling to clear the throat. As far as your nose is concerned, due to long standing inflammation, the mucosa starts to get edematous and ends up forming a polyp. I know the problem is there since a long five years, but I am not sure if you have followed any specific treatment chart which is usually recommended before we consider any patient for surgery. This treatment chart is custom made according to your symptoms and does follow the guidelines to treat both allergy with sinusitis. The following things can be considered. 1. Wear an n95 mask at all times, do not allow any dust or irritative substance from entering into your nose. This is the most important thing you should be following failing which, no treatment will bring any relief. 2. Tablet Sinarest (Paracetamol + Phenylephrine hydrochloride + Chlorpheniramine maleate) one tablet twice daily after food 12 hours apart for 15 days. 3. Tablet Allegra M (Fexofenadine and Montelukast) one tablet twice daily after food 12 hours apart for 15 days. 4. Tablet Zerodol TH (Aceclofenac and Thiocolchicoside) 4mg (or its equivalent) one tablet twice daily after food for five days. 5. Tablet Clarithromycin 500 mg one tablet twice daily after food. 6. Duonase nasal spray (or its equivalent) two puffs two times a day in both nostrils for three months (do not inhale while you spray the drug). 7. Tablet Mucomix 600 mg (Acetylcysteine) one tablet twice daily for 1 week. 8. Tablet Wysolone (Prednisolone) 10 mg one tablet after breakfast for 10 days. 9. Steam inhalations 3 to 4 times a day. 10. Saltwater gargles at 8 to 10 times a day for one month. 11. Do not smoke or consume alcohol as it slows down mucociliary clearance mechanisms. All precautionary measures have to be followed strictly for maximum relief, otherwise, medications would not be useful on the long term. Surgery can be considered (if above medications and precautionary measures do not give any relief), but there is a catch to it. The symptoms might come back sometimes even on a higher scale after a brief relief following surgery if the precautionary measures post surgery are not followed. Ideally speaking in a nutshell, I again emphasis on preventing any irritative substance from entering the nose and throat, thereby triggering an allergic cascade of events and reproducing the symptoms you have mentioned above. As far as the polyp is concerned, in very few cases the polyp resolves on its own with medications and often the patient requires a surgery called functional endoscopic sinus surgery where the sinus openings are widened and the polyps are removed. You will have to get a CT scan done to see the extent of the polyp, current condition of the other sinuses and anatomical variations in the nose which could have been contributing to the polyp. I hope this helps.

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Dr. Bhadragiri Vageesh Padiyar

Experience: 11 + Yrs

Otolaryngology (E.N.T)

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