What causes nasal congestion and reduced smell in a 33 y/o?

Question

Hello doctor,

I am a 33-year-old female who had surgery for nasal polyps nearly two years ago. Recently, I have noticed that my nasal congestion and reduced sense of smell are slowly returning. My ENT specialist has suggested doing saline rinses twice a day, along with using a steroid spray.

However, I am wondering whether saline rinses alone can prevent polyps from regrowing. Is it completely safe to do saline rinses long-term, or could they irritate my nose over time? Additionally, if polyps return despite regular care, does that mean another surgery will eventually be needed? I have also been experiencing more noticeable pressure around my cheeks recently.

Please guide.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your symptoms, particularly the pressure in your cheek area and the gradual loss of smell that occurred two years after your procedure, suggest a possible recurrence of chronic rhinosinusitis with nasal polyps. This is a common issue, as surgery tends to address physical obstructions but not the underlying inflammation of the disease.

For long-term management, regular saline irrigations combined with steroid sprays are considered the gold standard. These treatments are completely safe for prolonged use, do not irritate the mucosa when done correctly, and are essential for mechanically clearing allergens and reducing tissue swelling.

While this approach significantly reduces the chances of polyp regrowth, it does not guarantee that they will not return. However, if the polyps do recur, another surgery is not always necessary. Modern treatment options, including systemic medications or biologic therapies, can effectively manage the condition without requiring immediate surgical intervention.

I hope you find this information helpful.

Thank you for reaching out.