What could be the reason for chronic rhinosinusitis with polyps and upper airway obstruction?

Hello,

Thank you for stopping by! I am here to provide expert opinions on your medical issues. I am a 37-year-old female suffering from chronic rhinosinusitis with polyps. I am using the following medications: 1. Nasal steroid drops. 2. Oral antihistamine. 3. Vitamin D capsules. 4. Omeprazole. I have had a history of rhinitis/polyps for the past 14 years, it is treated with daily nasal steroids/(drops if bad) and an antihistamine - though all allergy tests have been negative. About two months ago (after a period of anxiety) I had been using the steroid drops and started to experience an odd intense tingle in my lower throat/below Adam's apple. This was followed by weeks of feeling as though my breathing was raspy, closed off at the throat (as though I was breathing through a pipe) and I heard a whistling noise through my mouth at night. At times my chest felt tight which made me panic. The symptoms of restricted throat breathing tend to occur on and off during the day. My doctor said it could be reflux and prescribed Omeprazole and a salbutamol inhaler. The Omeprazole seemed to help a little but the salbutamol did not so much. I had an ENT consultation (nasoendoscopy - it was clear) and a barium swallow which showed slight dysmotility but he did not think that the reflux was causing symptoms. He was not too concerned. I was told that my throat issues were likely anxiety and globus. My symptoms are a little better now but still present I have been trying to relax. I happened to have a spirometry appointment today which I was told was normal and above average apart from one thing - it showed some upper airway obstruction. He showed me the abnormal curve. The pulmonologist said that he would have recommended a camera down my throat but as I have had one it could be that I had my tongue in the way, inflammation, or unusual anatomy. I have an eight-week wait to see the respiratory consultant for a follow-up and have started to worry again. The area where I have symptoms and feel as though my breathing is restricted (Adam's apple/upper trachea) is where the test showed an obstruction. I am wondering when the ENT doctor said that he could not see anything on nasoendoscopy was he not able to see the whole throat/below the Adam's apple? What are the most likely causes of upper airway obstruction on respiration? How worried should I be? Also just to add I am awaiting blood test results due to recent intermittent livedo reticularis and a slight cramp in my left hand. Thank you.

Hello doctor,

I will ask the respiratory doctor to consider polysomnography. I do wear a health band (called whoop) every night which monitors respiration, oxygen saturation, and heart rate. This has not shown any abnormalities. I was wondering if it could be vocal cord dysfunction, but there have been no changes to my actual voice. At times throughout the day, I do feel some resistance in my breathing in the throat region. My nasoendoscopy was clear, do you think that this would show obstruction below the Adams Apple or does it not look that far down? Thank you.