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Cough, mucus, on flovent for asthma, nasal endoscopy, sinus CT scan, chest X-Ray, pulmonary test normal, allergy test positive. Treatment ?

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ENT Specialist
Practicing since : 1991
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Hi Doctor starting three months ago exactly I got sick like I never did before with just huge gobs of clear mucus choking me and I couldn't sleep for nearly 4 days. After that I had a cough for nearly 2.5 months which just went away about a week ago. I've seen an ENT who did a full nasal endoscopy, sinus ct scan (normal), transnasal endoscopy (normal), double ph probe (normal), chest xray (normal), pulmonary function (normal), allergy test positive (very high) for dust mites.

Medications I'm on - Flovent 250 for asthma.

I still feel mucus in my throat some days and some post nasal drainage and pressure in my cheeks and face when bending over. However they tell me that I don't have a sinus infection because of the negative CT scan. I really believe I have/had a sinus infection. Can you please advise any other tests to get, can I still have a sinus infection despite the ct scan? Any advice would be greatly appreciated.
Posted Thu, 3 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

1. If all the above investigations are normal, then only medication should heal your sinuses. There is minimal role for surgery in such cases.

2. An MRI may pick up a Allergic Fungal Rhinosinusitis (AFRS) while a CT Scan may not easily detect it.

3. You have already identified an allergy to dust mites and following dust mite control measures will improve your condition and reduce the severity of your asthma..

4. For your post nasal drip, take regular steam inhalation and saline nasal washes. After a bad bout of cold and cough, it takes many months for the inflammation within the sinuses to subside. You may need a course of nasal steroid spray as well.

5. The improvement in ventilation of the sinuses will help them heal and return to normal. There is always a normal mucus blanket flowing though the sinuses. When this slows down or stagnates due to disease, you can feel this as a post nasal drip.

6. You may be a candidate for Balloon Sinuplasty to enlarge the openings of the affected sinuses.

Hope I have answered your query. If you have any follow up queries, I will be available to answer them.

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