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ENT Dear Doctor ,My Wife Is 70 Year Old.She Has

Posted on Thu, 23 Jun 2022

Question: ENT
Dear Doctor ,My wife is 70 year old.She has nasal obstruction since 15 years or more. She gets nasal congesion occassionally and not able to cough up the phlegm out of her throat.We have shown to a physician who has prescribed some medicine long back. its of no use. I am herewith attaching the MRI scan taken in the year 2017 and also report.Please give your valuable suggestion and also prescribe a medicine for SOS.Some times she take Acebrophyllin 1 tab for 10 days .Temporarily subsides then again after some period she gets the trouble again.

Follow up: Dr. Dr.Raju.A.T (4 minutes later)

I have forgotten to attach the MRI and the report.Please help

Answered by Dr. Dr.Raju.A.T (13 hours later)

Brief Answer:
Need some more details

Detailed Answer:
Hi,

Thanks for your query

I have gone through the attached document

I would like to know some more details

Is she a diabetic ?
Has she been using nasal drops or spray ?
Was she advised surgery any time in the past ?

Waiting for your response

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Raju.A.T (3 hours later)

Dear Doctor, I am sorry in haste i have forgotten to give the details.Yes.
She is diabetic since2008.Her FBS and PP are very normal
FBS 100 pp 145.HB A1 c is 6.0. She is taking Glycomet Sr 500 one tab after breakfast.

She has mild Hypertension since 1996. Her bp is always normal 120/80 or 130/80.She takes Telma 40 and Amtas 2.5 mg after breakfast.

She has Hypothyroidsm since 2013.Her TSH level is around 3.5 to 4.5 always.She takes Thyronorm 50 mcg a day.

She was advised that surgery of no use.

She used to inhale nasivion long back.But not now.At times she does steaming with vics vaporub or eucalyptus .

If the discomfort is more, she takes Acebrophyillin in the morning and Montaire LC in the night for 5 days.then it subsides and give some gap for sometime.Will you please suggest some good medicine for her?

Answered by Dr. Dr.Raju.A.T (43 hours later)

Brief Answer:
Fluticone nasal spray

Detailed Answer:
Hi,

Thanks for the information.

Best treatment for such problems are topical decongestants.

You can suggest her fluticone nasal spray once in the morning daily, especially in winter season. She can titrate it to twice daily as per need.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Raju.A.T (2 hours later)

Dear Doctor
I thank you very much for your advise and which i will follow. but i would like to state that you have not given me her actual problem.
what is the diagnosis .You are silent on oral medicines which she is taking and its efficacy .Kindly clarify on the above two points

Answered by Dr. Dr.Raju.A.T (21 hours later)

Brief Answer:
Probable diagnosis - nasal congestion secondary to DNS

Detailed Answer:
Hi,

I can't be specific about diagnosis without examining her physically.

The suggestion is based on assumption that montelukast n levocetrizine is effective and the MRI shows left sided DNS- Deviated Nasal septum. This condition has to be corrected surgically as a permanent solution. Since it's not an option as you mentioned, then managing the congestion by medication is the only route.
Fluticasone spray works better in here.

I see no indication for acebrophylline, as it's a bronchodilator and I can't comment on that without examining the lung fields.

Regards,

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar