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Allergy, tickling in nasal passage, saline nasal spray

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ENT Specialist
Practicing since : 2001
Answered : 2291 Questions
Detection of Septum Problem :


Good day doctor.

After a road race last weekend, I had what felt like an allergic reaction to some wood smoke and was stuffed up for hours. I relieved the blockage with Afrin. Since then, I haven't been producing an mucus or had a runny nose, but have felt a slight tickling in my nasal passages when I inhale. It's not painful, just sort of weird-feeling, and has persisted for over a full week now. No other symptoms or illness.

On Monday, I went to my doctor, and he said I probably just had "a very low-grade cold." However, because of some issues in my past - I was a nose-picker as a kid, used to snort drugs (mostly ADD meds), hit my head a few weeks ago - I asked him to look and see if there was any structural damage to the inside of my nose. He looked and said that it looked perfectly healthy. My question is, would he have been able to see signs of a "perforated septum" from a cursory look (maybe 3-4 seconds looking in each nostril with that light/magnifying tool)? Or would this require a more specific test?

Also, any thoughts on how to make this tickling feeling go away? I've been using a saline nasal spray, which seems to offer only temporary relief.

Thanks in advance.
Posted Mon, 7 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 2 hours later

Thanks for the query

Stuffy nose with recurrent nasal discharge following exposure to wood smoke seems to be an exaggerated response to the allergens. You have already used pseudoephedrine (Afrin) to reduce the nasal congestion, but it has given you only temporary relief.

I feel you would require a steroid nasal spray and an antihistaminic to control nasal irritation. Also, continue using the saline nasal drops (it keeps the mucosa hydrated), drink plenty of warm water and do steam inhalation to relieve the nasal congestion and irritation.

According to the examination findings of your doctor, the nose seems to be clear and no signs of infection. It is also very unlikely that a doctor can miss a perforation of the nasal septum. The symptoms of the septal perforation include, recurrent episodes of dryness of the nose followed by nasal bleed, whistling sound while breathing (if the perforation is small only), any history of infection of nasal septum followed by pus discharge from the septal region, septal surgery, snorting of long duration, etc.

Most of the septal perforations happen in the front 1/3 of the nose rather than behind the nose, which can be seen easily, even on self examination using a mirror. And, hence it is very unlikely that a person can miss the perforation.

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
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