What could cause congestion in the left nostril?

Question

Hello doctor,

I have reduced sensation when breathing in through my left nostril, which is leaving me feeling panicked. My sense of smell on the left side is also diminished, which should not be the case since I have a deviated septum on my right side. It feels like my left nostril is underwater, with less sensation when air enters. Gently pressing my left nostril into the septum creates a strange, drowning sensation compared to pushing on my right nostril.

I am aware of the inferior turbinate function and suspect it may be related. An ENT I saw two weeks ago assessed my turbinates and said they did not appear enlarged. I have no symptoms of allergies, viral infections, or colds. There is a slight pounding sensation behind my left nostril, although the ENT mentioned there is clearer airflow on that side.

I stopped taking a decongestant nasal spray two and a half weeks ago due to concerns about rebound inflammation. I had been using it for nearly two months three days on and four days off. Currently, I am using Mometasone, a saline rinse, vitamin D tablets, and probiotics.

The symptoms have been persistent for one to two months. A chiropractor suggested an endonasal cranial adjustment, which involved inserting a balloon through my nostrils to attempt to correct the septum.

Kindly help

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Since you have been off the decongestant nasal spray for a couple of weeks, it is possible that your nasal tissues are still recovering from rebound congestion. Prolonged use of decongestants can cause rhinitis medicamentosa, leading to persistent nasal inflammation even after stopping the spray. This could explain the lingering sensations and the feeling of obstruction or discomfort in your left nostril.

The sensation of your left nostril feeling underwater or drowning may be linked to altered airflow or sensation in the nasal cavity. The turbinates (structures inside the nose that help regulate airflow and humidify air) play a crucial role here. Even if they appear not to be enlarged, they may still be contributing to your discomfort.

Procedures like an endonasal cranial adjustment can sometimes cause temporary swelling or changes in the nasal passages, and it may take time for the nasal structures to settle. You are already using Mometasone, and saline rinses are also beneficial. It can take several weeks for nasal tissue to fully recover from rebound congestion or inflammation.

I suggest you continue using the Mometasone and saline rinse consistently as prescribed, and avoid going back to decongestants. I suggest you follow up with your specialist doctor for further evaluation and physical examination.

Feel free to follow up with any questions or concerns as you move forward in your care.

I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.