Why do I have general anosmia, nasal dryness, and breathing difficulty for a year?

Question

Hi doctor,

Due to my extensive past trauma, I am experiencing a number of extremely disconcerting symptoms of otolaryngological variety. I have these symptoms for more than six months. I have done a septoplasty before three years. But it has deviated once more. I suspect it as turbinate hypertrophy or atrophic rhinitis. I have clicking or snapping sounds as a result of my past fracture. I have general anosmia. I have nasal pressure and localized numbness. I have altered airflow. I have a slight deformity in shape with a noticeable indentation on the left lateral nasal wall and a bit of broadening on the upper bridge. I have changes in the nasal passage due to changes in humidity and temperature. I have excessive dryness and difficulty in breathing. These symptoms got improved day by day. I have reached a debilitating stage. I have tourette's and OCD. Currently, I am taking Fluoxetine 40 mg daily. But I rely on Diphenhydramine to get good sleep at night. I realized that I have a problem and it requires a surgical correction. I am not opposed to surgery but I need to be pointed out in the right direction of treatment. Please help me.

Answer 1

Hi,

Welcome to icliniq.com.

Thanks for giving a detailed history. From your symptoms, you have mentioned that your likely diagnosis as severe vasomotor rhinitis associated with turbinate hypertrophy. In vasomotor rhinitis, you have persistent inflammation in the nasal cavity causing nasal obstruction and it is present for the whole day. It usually gets aggravated due to changes in temperature or changes in the surrounding environment. It can also occur due to intake of drugs taken for a significant period of time. You can have a diagnosis of turbinate hypertrophy. In this condition, inferior turbinates get increased in size and cause nasal obstruction. Inferior turbinates govern the boundaries of the internal nasal valve and it forms the rate-limiting segment for the entry of air and they contribute to the existing nasal obstruction. You can also have another diagnosis of empty nose syndrome. To confirm, it is necessary to do a CT (computed tomography) scan of the nose and paranasal sinus along with nasal endoscopy. It occurs as a result of overcorrection of nasal septum and over-reduction of turbinates. It can be performed in you as a part of the surgery. Excessive removal causes paradoxical nasal obstruction. Deviated nasal septum can also cause these symptoms. I suggest you do a non-contrast computed tomography of the nose and paranasal sinus along with nasal endoscopy to identify the cause of your problem. For now. you can follow these treatment options. Use Duonase nasal spray (Fluticasone propionate with Azelastine) two puffs in each nostril two times a day for six weeks. Do not inhale while spraying this drug from the device. Once you get it, you can breathe normally. You can use Otrivin nasal drops three drops times a day for the next ten days. This is a decongestant nasal drop containing Xylometazoline and it helps in decongesting the nasal cavity. Avoid triggering factors causing congestion. Have a follow-up with the results of the reports.