Hi,

Thank you for your query.

1. Get a nasal examination and a plain CT PNS (Para Nasal sinuses) done to assess your DNS (Deviated Nasal septum) and to rule out Hypertrophied Nasal Turbinates, Nasal Polyps and Sinusitis. These are the most common causes of nasal obstruction. The white nasal discharge may be allergic, infected or fungal in nature. The sinuses have a large surface area, therefore toxins from even a minor sinus infection are readily absorbed and give rise to nausea, feverishness, weakness and low energy. The CT PNS Scan is the gold standard investigation to differentiate between allergy and sinusitis.

2. If your nose is severely blocked, you may use a few drips of an OTC nasal decongestant drop such as Otrinoz or Otrivin. The action of these drops usually lasts for 10-12 hours. There may be some rebound congestion after this time. Do not use these drops for more than two weeks continuously.

3. Start an anti-allergic and an anti-leukotriene such as Monatir FX or Rupanex M once a day . A Steroid nasal spray such as Nasonex (Mometasone) should be started once a day in each nostril. Kindly take these medications under the strict care of a doctor.Take a trial of these medicines for at least 15 days.

4. If steam inhalation does not help much, then you probably have a significant nasal obstruction. In such cases I recommend a CT PNS Scan pre and post decongestion with Otrivin Nasal Drops.

5. There is no cure for allergy. However it may be controlled. You have a problem with cold AC environment which is a non specific allergy. It is very difficult to always avoid such an environment. However using a mask at times will help reduce your exposure to sudden changes in temperature.

6. Do you have sneezing, nasal discharge or eye symptoms? Do you snore in your sleep? Is your nose obstructed at all times or intermittently?

7. GERD (Acid reflux) worsens due to a Post Nasal Drip (PND) and a PND or Sinsuitis will worsen due to GERD (Acid reflux). Thsi sets up a vicious cycle which has to be broken for relief to be obtained.

8. You may follow up here with your test results. If the above mentioned medical treatment works then there is no need of any surgery. New treatment besides options Septolplasty and FESS (Functional Endoscopic Sinus Surgery) include Radio-frequency ablation of nasal turbinates and Balloon Sinuplasty.

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

Regards.

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Hi,

Thank you for your writing back.

1. Any Scan center with a Multi-slice CT Scan Machine will be fine. Specifically it is a plain CT PNS with 1 mm coronal, axial and sagittal cuts.

2. You should take a trial of the above mentioned medication for 15 days before considering a CT Scan.

3. There exists a normal nasal cycle that blocks the nose alternately every 4-7 hours. We are normally not aware of this. This has been disturbed by some cause and hence you are now aware of this nasal obstruction probably because the other side is also partially blocked at all times.

4. I recommend a CT Scan when you are feeling blocked. The Otrivin drops are administered and the CT Scan repeated after 10 minutes. The images can then be compared and co-related with the opening up of the nose. The charges are for one scan only as a routine scan includes two scans usually with a contrast XXXXXXX injection. Instead of the contrast XXXXXXX a plain scan is done before and after the use of Otrivin nasal drops.

5. This will help in understanding the basis of your nasal obstruction. You may share the CT images (not the report) for further advice.

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

Regards.

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