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Have swollen face with a burning sensation and mucus discharge from nose. What's wrong?

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ENT Specialist
Practicing since : 1991
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Tried posting on ehealth but it's not appearing for some reason: for years I've had a swelling on the right side of my face, along with a burning sensation. I finally bought a $15 scope and had a look...this is what is at the back of my nose every morning [adenoid?]. Note the thick mucus and the little white bump.

What is this? Can anything be done about this?

picture "morning 1" - what is on my adenoid every morning.

picture "morning 2" - what is underneath all that nonsense. There are more spots above

picture "morning 3" - with the mucus cleared out. The eustachian tube continually drips too.

picture "morning 4" - mucus on a tissue

This affects my sleep, concentration, weight...pretty much everything and would be nice to have it resolved somehow. The doctors don't know what is wrong with me.
Posted Sat, 23 Feb 2013 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 8 hours later

Thank you for your query.

1. The first image shows some adenoid tissue and the thick mucus. It is blurred and hence difficult to orient. No other landmarks are seen. The 2nd & 3rd image do not open on Image Shack. The 4th image with the thick mucus on a paper tissue is clear.

2. Seeing your previous operative history, it should be a simple procedure to get a nasal endoscopy done and upload the video here.

3. Do you have any details (operative notes, discharge summaries) of the previous surgeries?

4. Adenoid tissue usually does not persist in an adult. However , it may hypertrophy in a few cases. Other structures that need to be ruled out is a Thornwaldt's bursa or cyst.

5. Imaging (Lateral Skull X-ray for adenoids and plain CT PNS - Para Nasal SInuses) will settle the issue. The source of this mucus will be discovered.

6. A regards the mucus dripping put of the Eustachian Tubes is concerned, if your ear examination and hearing tests (Pure Tone Audiogram and Tympanometry / Impedance Audiogram) are within normal limits, there is no cause for worry. Can you share an image or video depicting this?

7. In the meanwhile, an anti-histamine, an anti-leukotriene, a steroid nasal spray and regular steam inhalation will help reduce the mucus.

8. You may also get your throat examined and upload an image here. Usually, Granular Pharyngitis is commonly seen in cases with a sever post nasal drip of mucus. Latest CT images of the nose and sinuses will help.

I hope I have answered your query. Please reply back with the answers and I will be able to help you further.

Above answer was peer-reviewed by
Follow-up: Have swollen face with a burning sensation and mucus discharge from nose. What's wrong? 20 hours later
1. I have uploaded many images that show the adenoid over several days.
a) There is a yellowish object that can be seen in the picture in the middle column, first row. I guess that the mucus is generated principally in this area and this object is the cause of much physical pain. It can be seen again in the two second row pictures.

b) The three middle column pictures depict liquid that comes from the eustachian tube area. This seems to be happening on both sides but causes more grief on my right.

c) Row three of the third column: I can reach through my mouth and all the way up. The fold my finger is pointing at also hurts regularly, and there seems to be some kind of opening here as when the sand-like deposits are cleared in the morning, I immediately feel less stuffy and lot better (as if a plug was removed).

d) Row one of the first column: when I flex my throat it causes palpitations inside my head. This picture is looking through my right nostril as the skin is motioned upwards. Along with this I get a lot of “clicking” in my head. An opthalmologist I consulted suspects air sockets. When I apply a lot of pressure to the deviated nose bone (I push hard on my left side), it gives me relief: I feel air reaching areas it does not normally, and pressure is reduced by my right eye and over by my right ear. I am told this does not make medical sense.

e) Last picture third column: This is my right palatine tonsil. I can feel when grit collects in the lobe at the bottom. I also get relief by liberating the stones that slide down from behind it when I raise the skin near the top. This was lasered in 2012.

f) I occasionally feel throbbing at the top and bottom left of my head, which I can relieve to some degree with “clicking.” It feels that something is pulsating. It generally does not last more than twenty minutes.

2. My next appointment with my local ENT is February 11th. Is this something I can propose to him? What would I say or should he know exactly what you would be looking for? To some degree, I also fear being dismissed as a patient if I am too pushy as this has been confusing and irritating doctors for a long time.

3. I do not have operative notes. Regarding discharge, after my surgery I remember mucous and blood being trapped up above in my right sinus for a while. Discharge there now is usually liquid or what you can see in the pictures. My left side produces white sticky mucous: I have to raise the left side skin in order to get it out when enough of it collects.

4. Is one able to observe a Thornwaldt's bursa or cyst in the above set of pictures (the white object that is painful)?

5. I have uploaded CT images to this gallery:
If you would like more of a certain region I can certainly provide those. The lateral X-ray for adenoids is something I would like to suggest to my local ENT on February 11th.

6. I had a test and it is within normal limits. I do not have any media for this.

7. Thank you for your recommendation. (“an anti-histamine, an anti-leukotriene, a steroid nasal spray and regular steam inhalation will help reduce the mucus.”)

8. CT images uploaded above (point #5). I also had a swallowing test done recently as it felt as if something was caught in my throat ; I do not yet have the results.
Answered by Dr. Sumit Bhatti 21 hours later

Thank you for writing back.

1. You have taken a lot of effort to capture the images.

2. There is normally a mucus blanket in the nose, sinuses and throat that protects it. There are microscopic cilia that beat within the two layers (slow/gel & fast/liquid) and cause the mucus to flow into the throat from where it is swallowed or expelled.

3. The mucus seems clear and allergic in some images. The quantity, though, is not alarming. This should subside with medical treatment.

4. The CT images are not accessible. Kindly upload them again.

5. Tonsilloliths are concretions of food particles lodged in the natural crypts of the palatine tonsils. The largest crypt is known as the crypta magna and is located near the upper pole of the palatine tonsil.

6. When we swallow, our palatine tonsils rub against the food bolus and pick up food particles. This food debris decays there while it is analysed for antigens, foreign bodies and organisms by the lymphoid tissue which forms the bulk of the tonsils. Below the age of five years, this is especially important in the development of immunity.

7. For recurrent large tonsilloliths, the only definitive treatment is a tonsillectomy.

8. Do you have halitosis (bad breath)? You may try regular use of a medicated gargle and continue manually expressing them while brushing your teeth. You must brush at night. This reduces bacterial build-up.

I hope I have answered your query. Please reply back with the answers and I will be able to help you further.

Above answer was peer-reviewed by
Follow-up: Have swollen face with a burning sensation and mucus discharge from nose. What's wrong? 12 hours later
Hi Dr. Bhatti,

Thank you for all the advice and information.

1. The clear mucus is what is left after the thick stuff is cleared or falls into my throat. Generally, the drip from the eustachian tube(?) seems to be clear.

2. CT images: WWW.WWWW.WW
3. I googled "Thornwaldt" and to me, the yellow spot in my adenoid seems very similar to the pictures I discovered. I uploaded the above CT, and I should focus on getting an x-ray then (perhaps)?

4. I don't have noticeable bad breath. Only once has a family member commented, and that was right after waking up. Sometimes, however, I can suddenly smell a foul odour coming from inside that eventually goes away.

5. In 2008, I went to Scotland. In the highlands, a liquid was released from somewhere in my nose and trickled down into my throat. It burned its way down and I caught a very bad cold instantly which lasted for several days. My mother and sister both eventually caught the illness. For me, it was so sudden: within a minute, I went from well enough to very ill.

5. Here are today's adenoid pictures. I wake up with this every morning.
5. In regards to the picture of my face:
*I use the electrical tape to stretch the bottom of the nose to align it to the deviated bone. This makes me feel a lot better.
*When I push very hard on the bone where my finger is, I feel a lot better (either passages are opened or there is drainage, or both?) My head "clicks" a lot before I feel better.
*Note that my eyebrows are at different levels and that one side of my face seems stretched.
*I have a slightly misaligned jaw as well (overbite). On the side where my finger is, there is quite a bit more space between the bone and the neck than on the other side. That is also the side (where my finger is) that I get numbness and occasional palpitations in my head.

Thank you so much! You have a lot of patience for me. This is the last follow-up WWW.WWWW.WW is letting me have for now, but when I have more questions to ask you through this service, will it be easy enough to reach you?

Have a great weekend.
Answered by Dr. Sumit Bhatti 13 hours later

Thank you for writing back.

1. Your CT images show a DNS (Deviated Nasal Septum) to the Left with a deviated maxillary crest and a bony spur on the Left. There is no sinusitis. The small mucus retention cyst in the Left Maxillary Sinus may require no treatment and the small opacified Ethmoidal Sinus Cell will settle with medication. The Right Middle Turbinate Lamellar Cell (of Grunwald) is also opacified. These are changes of minor sinusitis that responds to medication. There is minimal adenoid tissue in the nasopharynx and no obvious Thornwaldt's cyst either. Probably, you have a simple mucus retention cyst, if any.

2. What you do with the electrical tape is very similar to the Cottle's Test which gives similar relief in a parson with DNS. Your CT shows a significant carilage deviation and narrowing of the left nostril. This is the area of the nasal valve. If you have nasal obstruction, a Septoplasty will give relief.

3. The clicking is due to the forced movement of the nasal cartilage framework with respect to the facial bones. This is common and not a cause for concern.

4. Get you overbite checked by a dentist. A misaligned jaw puts stress on the TM (Temporo Mandibular) joints, muscles and gives rise to many such symptoms.

5. The sudden trickle burning down your nose and throat and 'instant' cold is common. It is usually stagnant, infected mucus. The fact that your mother and sister caught it means that there probably was a sudden temperature change or a viral infection involved.

6. I would again emphasize that your problem looks minimal and should respond to medication. You may redirect any question in the future directly to me or at

Wishing you a speedy recovery,

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