Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Persistent Nasal Congestion
Question: Hi my husband has had problems for a few years, he was congested and his nasal passages seemed obstructed. Eventually 2 years ago we saw a different ENT doctor who said it was a deviated septum. My husband also mentioned the pressure in his head and ears but nothing was done about it.
He had a septoplasty 6 months later but still couldn't breathe. He was then told he had scar tissue so had another procedure to remove it.
He is still having major problems with his ears and head and it's getting worse. He gets dizzy, pain around his skull with tightening as if being squeezed in a vice and it's going to pop, blocked ears, tinnitus, can hear his heartbeat, sore throat, constant mucus drip which makes him cough or choke, his nose is always full of mucus and he can't breathe properly, ears popping or cracking, trickling sensation under eyes, the cranial pain is mainly behind his right ear and the skull above right ear.
He wAs given a hearing test and told his right ear had hearing loss.
He's had an MRI on his ears and told fine. He was referred to neurology and told migraines but we know it's related to his nose and ears. He's still under ent and we're waiting for results of a ct scan on his sinuses plus neuorolgy want another MRI on head.
My husband constantly blows or clears his nose and has done this for over 2 years as he says a plug of mucus gets stuck. He can pin point when the problems started and it wAs over 2 yrs ago before his septoplasty when he blew really hard and felt hot and dizzy and felt his ear go funny.
Iam sure ent aren't taking it seriously it's ruining his life he's so depressed.
He had a septoplasty 6 months later but still couldn't breathe. He was then told he had scar tissue so had another procedure to remove it.
He is still having major problems with his ears and head and it's getting worse. He gets dizzy, pain around his skull with tightening as if being squeezed in a vice and it's going to pop, blocked ears, tinnitus, can hear his heartbeat, sore throat, constant mucus drip which makes him cough or choke, his nose is always full of mucus and he can't breathe properly, ears popping or cracking, trickling sensation under eyes, the cranial pain is mainly behind his right ear and the skull above right ear.
He wAs given a hearing test and told his right ear had hearing loss.
He's had an MRI on his ears and told fine. He was referred to neurology and told migraines but we know it's related to his nose and ears. He's still under ent and we're waiting for results of a ct scan on his sinuses plus neuorolgy want another MRI on head.
My husband constantly blows or clears his nose and has done this for over 2 years as he says a plug of mucus gets stuck. He can pin point when the problems started and it wAs over 2 yrs ago before his septoplasty when he blew really hard and felt hot and dizzy and felt his ear go funny.
Iam sure ent aren't taking it seriously it's ruining his life he's so depressed.
Brief Answer:
CT Scan Paranasal Sinuses and CT Scan Brain needed to find out the cause.
Detailed Answer:
Hi XXXX,thank you for posting your query on Health Care Magic.
I can understand your concern.
Many symptoms of your husband might be due to nasal blockage.The common causes of nasal blockage are Deviated nasal septum, Sinusitis(Inflammation of sinuses), Enlarged Adenoid (Adenoid is a lymphoid tissue found in back of your nose and may get enlarged in case of allergy or infection). All these pathology can be found out in a CT Scan Paranasal Sinuses.
Nasal Blockage might occur in a case of Allergic rhinitis(Inflammation of nasal cavity due to Allergy)- in which case patient suffers from sneezing,watery nasal discharge,nasal blockage,etc on exposure to irritants.
Nasal blockage may lead to blockage and collection of fluid in sinuses due to which your husband might be suffering from symptoms like Headache,pressure in head. The nasal secretions may trickle in the throat leading to cough and inflammation of throat leading to throat pain.Nasal blockage might lead to blockage of Eustachian tube. It is a tube which connects the middle ear and nose and is responsible for equalization of middle ear pressure with the outer atmospheric pressure. In case of blockage of this tube, the middle ear pressure is not able to remain equal with the outer atmospheric pressure leading to negative middle ear pressure and fluid collection (which might get infected) in middle ear leading to symptoms like ear blockage,ear pain, reduced hearing,tinnitus,giddiness,etc.
You husband had undergone septoplasty surgery and a surgery later to remove the scar tissue but still the complain of nasal blockage is not completely recovered .In such a case to find out the cause ,Nasal endoscopy( by an ENT Specialist) and CT Scan Sinuses is needed.(CT Scan sinuses helps to find out the cause of nasal blockage,to find out whether sinuses are involved,to find out whether adenoid is enlarged,etc)
The hearing test of your husband show reduced hearing in right ear. Hearing loss might be Conductive(in which the cause is in outer or middle ear like fluid collection in middle ear, ear infection,etc) or Sensorineural( in which the nerve responsible for hearing sensation is involved-the cause might be unknown). Tinnitus and giddiness might also occur due to nerve involvement. In a case of sensorineural hearing loss,giddiness,tinnitus, MRI Ear might be required to find out any pathology in inner ear or nerve. I am happy to hear that your husband's MRI Ear is normal.
If your husband is suffering from Migraine, then he may be suffering from symptoms like Pain on one side or both sides of your head, Pain that feels throbbing or pulsing, sensitivity to light, sounds, and sometimes smells and touch, Nausea and vomiting, Blurred vision, Lightheadedness, sometimes followed by fainting. A migraine attack usually lasts from 4 to 72 hours if untreated.
Hearing of sounds of heart beat might occur in a case of increased blood pressure in brain(Intracranial hypertension) or due to vascular abnormality.In such a case ,consultation with a neurologist and MRI Brain might be needed.I am happy that you have already consulted Neurologist and going for MRI Brain.
It would be advisable to follow-up with an ENT Doctor with reports of CT Scan Sinuses, so that he may find the cause of nasal blockage and treat accordingly.
It would also be advisable to follow-up with Neurologist doctor with MRI Brain to rule out any pathology in brain.
Till then, your husband may find relief by taking medicines like:
Oral decongestant (like Phenylephrine) and Nasal Decongestant (like Xylometazoline) if your husband is not suffering from hypertension, antihistaminic (like Cetirizine), Analgesic (like Ibuprofen) with Antacid(like Rantac) and a Cough Expectorant(like Ambroxol).
Also do steam inhalation. Avoid dust, smoke and other pollutants. Avoid cold and very sweet food(as it increases mucus secretions). Drink lots of water (warm) as it helps in breaking of mucus secretions. Do warm saline gargles twice to thrice daily.
Hope this answers your question.I would be happy to answer if you have any follow-up questions.
Get well soon .
Regards
CT Scan Paranasal Sinuses and CT Scan Brain needed to find out the cause.
Detailed Answer:
Hi XXXX,thank you for posting your query on Health Care Magic.
I can understand your concern.
Many symptoms of your husband might be due to nasal blockage.The common causes of nasal blockage are Deviated nasal septum, Sinusitis(Inflammation of sinuses), Enlarged Adenoid (Adenoid is a lymphoid tissue found in back of your nose and may get enlarged in case of allergy or infection). All these pathology can be found out in a CT Scan Paranasal Sinuses.
Nasal Blockage might occur in a case of Allergic rhinitis(Inflammation of nasal cavity due to Allergy)- in which case patient suffers from sneezing,watery nasal discharge,nasal blockage,etc on exposure to irritants.
Nasal blockage may lead to blockage and collection of fluid in sinuses due to which your husband might be suffering from symptoms like Headache,pressure in head. The nasal secretions may trickle in the throat leading to cough and inflammation of throat leading to throat pain.Nasal blockage might lead to blockage of Eustachian tube. It is a tube which connects the middle ear and nose and is responsible for equalization of middle ear pressure with the outer atmospheric pressure. In case of blockage of this tube, the middle ear pressure is not able to remain equal with the outer atmospheric pressure leading to negative middle ear pressure and fluid collection (which might get infected) in middle ear leading to symptoms like ear blockage,ear pain, reduced hearing,tinnitus,giddiness,etc.
You husband had undergone septoplasty surgery and a surgery later to remove the scar tissue but still the complain of nasal blockage is not completely recovered .In such a case to find out the cause ,Nasal endoscopy( by an ENT Specialist) and CT Scan Sinuses is needed.(CT Scan sinuses helps to find out the cause of nasal blockage,to find out whether sinuses are involved,to find out whether adenoid is enlarged,etc)
The hearing test of your husband show reduced hearing in right ear. Hearing loss might be Conductive(in which the cause is in outer or middle ear like fluid collection in middle ear, ear infection,etc) or Sensorineural( in which the nerve responsible for hearing sensation is involved-the cause might be unknown). Tinnitus and giddiness might also occur due to nerve involvement. In a case of sensorineural hearing loss,giddiness,tinnitus, MRI Ear might be required to find out any pathology in inner ear or nerve. I am happy to hear that your husband's MRI Ear is normal.
If your husband is suffering from Migraine, then he may be suffering from symptoms like Pain on one side or both sides of your head, Pain that feels throbbing or pulsing, sensitivity to light, sounds, and sometimes smells and touch, Nausea and vomiting, Blurred vision, Lightheadedness, sometimes followed by fainting. A migraine attack usually lasts from 4 to 72 hours if untreated.
Hearing of sounds of heart beat might occur in a case of increased blood pressure in brain(Intracranial hypertension) or due to vascular abnormality.In such a case ,consultation with a neurologist and MRI Brain might be needed.I am happy that you have already consulted Neurologist and going for MRI Brain.
It would be advisable to follow-up with an ENT Doctor with reports of CT Scan Sinuses, so that he may find the cause of nasal blockage and treat accordingly.
It would also be advisable to follow-up with Neurologist doctor with MRI Brain to rule out any pathology in brain.
Till then, your husband may find relief by taking medicines like:
Oral decongestant (like Phenylephrine) and Nasal Decongestant (like Xylometazoline) if your husband is not suffering from hypertension, antihistaminic (like Cetirizine), Analgesic (like Ibuprofen) with Antacid(like Rantac) and a Cough Expectorant(like Ambroxol).
Also do steam inhalation. Avoid dust, smoke and other pollutants. Avoid cold and very sweet food(as it increases mucus secretions). Drink lots of water (warm) as it helps in breaking of mucus secretions. Do warm saline gargles twice to thrice daily.
Hope this answers your question.I would be happy to answer if you have any follow-up questions.
Get well soon .
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Hi thanks for that, unfortunately we know everything you have mentioned as I have done a lot of study. This has been going on for over 2 years. The septoplasty was 1 half years ago and the scar tissue removal was the summer.
The MRI was mainly on the ears and came back negative for anything sinister or any blocked ears.
The surgeon said he checked sinuses when he did the scar removal but a ct scan was only done recently so is it possible that there is something hidden that couldn't be seen when the operation was done?
The neurologist said the ct scan looked ok but is he best to advise rather than the ent?
The migraine tablets helped with pain but the numbness and pressure and blocked ears is still there all day every day for 2 years. This can't be migraine.
I personally think he had blocked sinuses before septoplasty and it's never been treated. He feels like his head is being squashed and numbness mainly right side cranial. He's never had allergies and ent said shouldn't happen as he reduced turbinates.
Could he have damaged something when he blew his nose? He doesn't sneeze or anything just mucus gets plugged in nasal cavity and drip down his throat.
The MRI was mainly on the ears and came back negative for anything sinister or any blocked ears.
The surgeon said he checked sinuses when he did the scar removal but a ct scan was only done recently so is it possible that there is something hidden that couldn't be seen when the operation was done?
The neurologist said the ct scan looked ok but is he best to advise rather than the ent?
The migraine tablets helped with pain but the numbness and pressure and blocked ears is still there all day every day for 2 years. This can't be migraine.
I personally think he had blocked sinuses before septoplasty and it's never been treated. He feels like his head is being squashed and numbness mainly right side cranial. He's never had allergies and ent said shouldn't happen as he reduced turbinates.
Could he have damaged something when he blew his nose? He doesn't sneeze or anything just mucus gets plugged in nasal cavity and drip down his throat.
Brief Answer:
CT Scan Sinuses would help in finding out the cause of nasal blockage
Detailed Answer:
Hi XXXX,
Thank you for your reply.
I am glad to learn that you have studied so much.
Nasal Endoscopy and CT Scan Sinuses together will give a greater idea to find out the cause of nasal blockage. CT scan sinuses help in identifying any obstruction in sinus opening with more clarity. Which sinuses are affected and how much affected will also be seen in clarity in CT Scan.
It is definitely possible that CT Scan will help to find out the cause for nasal blockage which could not be found out during septoplasty and scar removal surgery.
As per your thinking, blockage of sinuses and resulting inflammation might be a cause which needs treatment. It can be diagnosed with the help of CT Scan Sinuses.
Yes, blowing the nose hard can create enough pressure in the nasal cavity to propel mucus into the sinuses leading to sinus infection and may also send infection from the nose to the inner ear and cause an ear infection.
Due to nasal blockage, the nasal secretions may not be able to come out, so they may be passing backwards in the throat.
To review CT Scan Sinuses, an ENT specialist would be the person to be consulted with the help of CT Scan reporting by a Radiologist.
Hope this answers your query, please feel free to ask in case of any further doubts.
Take care.
CT Scan Sinuses would help in finding out the cause of nasal blockage
Detailed Answer:
Hi XXXX,
Thank you for your reply.
I am glad to learn that you have studied so much.
Nasal Endoscopy and CT Scan Sinuses together will give a greater idea to find out the cause of nasal blockage. CT scan sinuses help in identifying any obstruction in sinus opening with more clarity. Which sinuses are affected and how much affected will also be seen in clarity in CT Scan.
It is definitely possible that CT Scan will help to find out the cause for nasal blockage which could not be found out during septoplasty and scar removal surgery.
As per your thinking, blockage of sinuses and resulting inflammation might be a cause which needs treatment. It can be diagnosed with the help of CT Scan Sinuses.
Yes, blowing the nose hard can create enough pressure in the nasal cavity to propel mucus into the sinuses leading to sinus infection and may also send infection from the nose to the inner ear and cause an ear infection.
Due to nasal blockage, the nasal secretions may not be able to come out, so they may be passing backwards in the throat.
To review CT Scan Sinuses, an ENT specialist would be the person to be consulted with the help of CT Scan reporting by a Radiologist.
Hope this answers your query, please feel free to ask in case of any further doubts.
Take care.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Hi if the ct and MRI come back clear, what is the next step?
Brief Answer:
Rule out other causes
Detailed Answer:
Hi,if the CT scan paranasal sinus is normal,then even if there is no anatomical abnormalities in the nose or sinus passages,other causes should be ruled out for causing Chronic symptoms to your husband suggestive of chronic rhino-sinusitis like:
Allergy-Allergy testing can help to find out which allergens your husband is sensitive and to avoid those allergens,
GERD(Gastro-esophageal Reflux Disease)-it also plays a role in a few patients in Chronic rhino-sinusitis,
Dental disease,
Smoking,
Environmental irritants and pollutants,etc.
If the MRI Brain is normal,then the reason for hearing heart beat sounds in ear might be due to increased blood flow due to Anemia,hyperthyroidism,etc which needs to be ruled out by blood tests.
Hope this answers your question.Take care.
Rule out other causes
Detailed Answer:
Hi,if the CT scan paranasal sinus is normal,then even if there is no anatomical abnormalities in the nose or sinus passages,other causes should be ruled out for causing Chronic symptoms to your husband suggestive of chronic rhino-sinusitis like:
Allergy-Allergy testing can help to find out which allergens your husband is sensitive and to avoid those allergens,
GERD(Gastro-esophageal Reflux Disease)-it also plays a role in a few patients in Chronic rhino-sinusitis,
Dental disease,
Smoking,
Environmental irritants and pollutants,etc.
If the MRI Brain is normal,then the reason for hearing heart beat sounds in ear might be due to increased blood flow due to Anemia,hyperthyroidism,etc which needs to be ruled out by blood tests.
Hope this answers your question.Take care.
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. Nagamani Ng
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
