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I Have Nasal Polyps And Planing To Go For Surgery

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Posted on Fri, 14 Jun 2019
Question: I have nasal polyps and planing to go for surgery next month.
Hiwever, i also have eye pressure and currently taking eye drops to keep it under control. I came to know of it after i had a surgery for ratina detachment.
For polyps i am taking flomist spray and i feel it may effect my eye pressure.
I also want to ask if oxymethazoline nasal drops would be ok to ease my breathing despite the above medical conditions.
doctor
Answered by Dr. Sumit Bhatti (8 hours later)
Brief Answer:
Safe for short interval, intermittent use.

Detailed Answer:
Hi,

Thank you for your query.

1. Local steroid sprays and nasal decongestant drops should be safe for use for less than two weeks at a time. Longer duration use is associated with increase in intra-ocular pressures and hypertension (elevated blood pressure).

2. Since you are planning to undergo surgery for the nasal polyposis in a month, intermittent use before the nasal surgery should be fine.

3. Get your IgE levels and specific allergy tests done. If IgE is low, low dose long term macrolide antibiotics may help by immune modulation. Specific allergen avoidance will also help. Nasal irrigation with saline will also help to ease your breathing till the surgery. Adding steroid to the nasal wash for a few days will also help. Such precautions are necessary as bilateral nasal polyps are notorious for recurrence after surgery. However, in your case, nasal polyp surgery will help decrease local inflammation near the eyes which will help ease your eye conditions.

4. You may share your sinus CT scan images here for further guidance and discussion.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sumit Bhatti (2 hours later)
Thank you very much for detailed answer. it is very helpful. Dr, I also like to know your opinion on that at times again i used to get an extremely dry tongue. its very dry on top and is white in color.
I am not sure if it is related to the polyps or something else.
i have attached a pic taken after wake up from sleep.
doctor
Answered by Dr. Sumit Bhatti (1 hour later)
Brief Answer:
Details as discussed below:

Detailed Answer:
Hi,

Thank you for following up.

1. The dry white coated tongue is due to nasal blockage because of the nasal polyps and resultant mouth breathing. This should improve after the nasal polyp surgery relieves nasal obstruction.

2. Add half an ampoule of Budecort respules to each 200-250 ml of saline nasal wash.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Sumit Bhatti (1 minute later)
Also how can i add the flomist to Saline? I also think that would be more heloful rathar than spray.
please guide me of a posdible way i can mix them. i have send pictures of both.
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Follow up: Dr. Sumit Bhatti (1 hour later)
Can i use this capsule? And normall saline solution to mix?
doctor
Answered by Dr. Sumit Bhatti (7 hours later)
Brief Answer:
Details as discussed below:

Detailed Answer:
Hi,

Thank you for following up.

1. Adding Flomist to saline is not helpful as the dose is in 50 micrograms per spray (very low). As it is a mist spray, it will be difficult to add to the saline. Flomist also contains benzalkonium chloride as a preservative. Same with Foracort 200 capsule which contains 22 micrograms of budesonide per capsule. In addition, the Foracort 200 capsule also contains formoterol which is a bronchodilator. Hence not recommended.

2. Budesonide respules are 0.5 milligrams per 2 ml. Add 1 ml (250 micrograms) to each hypertonic (2%) saline nasal wash such as Nasowash. These budesonide respules are preservative free.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

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. Raju A.T
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2686 Questions

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I Have Nasal Polyps And Planing To Go For Surgery

Brief Answer: Safe for short interval, intermittent use. Detailed Answer: Hi, Thank you for your query. 1. Local steroid sprays and nasal decongestant drops should be safe for use for less than two weeks at a time. Longer duration use is associated with increase in intra-ocular pressures and hypertension (elevated blood pressure). 2. Since you are planning to undergo surgery for the nasal polyposis in a month, intermittent use before the nasal surgery should be fine. 3. Get your IgE levels and specific allergy tests done. If IgE is low, low dose long term macrolide antibiotics may help by immune modulation. Specific allergen avoidance will also help. Nasal irrigation with saline will also help to ease your breathing till the surgery. Adding steroid to the nasal wash for a few days will also help. Such precautions are necessary as bilateral nasal polyps are notorious for recurrence after surgery. However, in your case, nasal polyp surgery will help decrease local inflammation near the eyes which will help ease your eye conditions. 4. You may share your sinus CT scan images here for further guidance and discussion. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.