Hi

Thanks for the query

The symptoms you have described are the features of Allergic rhinosinusitis.

Allergic rhinitis is a common condition characterized by an immunoglobulin E (IgE)-mediated inflammation of the nasal mucosa following exposure to allergens. It is characterized by sneezing, nasal discharge and nasal congestion.

During allergic rhinitis there is inflammation of the nasal mucosa causing blockage of the sinus openings leading to accumulation of the nasal secretions in the sinus. Also, there is trickling of the nasal secretions behind the throat causing throat discomfort and cough.

The common triggerers of allergy are the pollen, dust, fumes, coils smoke, etc. The bitter truth is, there is no cure for allergy, and only the preventive measures when followed can get rid of allergy.

Preventive measures such as avoiding the triggering allergens such as dust, smoke, strong perfumes and changing the pillow cover every night before going to bed can reduce the further attacks. Also, avoid sleeping directly under the fan or in front of the air conditioner.

Now, let’s discuss about the CT scan report:
There is osteomeatal complex (OMC)block on both the sides. Which means the opening of the maxillary, anterior ethmoidal and frontal sinuses are all blocked that can trap the secretions, raise the pressure in the sinuses and cause headache.

This OMC has to be opened up in order to ensure free drainage of the sinus secretions. I do feel there is no need of surgery at this stage because the nose is not treated adequately and not all the medicines prescribed are appropriate for this condition.

Wait for few months; once you start using the correct medicines, the problem might resolve and surgery would not be required.

My advice to her is:
1. To continue steroid (momentasone) nasal spray once a day.
2. To use saline nasal spray followed by steam inhalation 3-4 times a day, this will help in opening of the sinuses and easy clearance of the sinus secretions.
3. To use a mucolytic such as Bromhexine and Ambroxol, this helps in thinning of the tenacious secretions.
4. To change the antibiotic Formic XL. Instead, use either a combination of Amoxycillin and Clavulanic acid or Cefuroxime, the former and the latter are the drugs of choice for this condition.
5. To drink plenty of warm water and to avoid chilled food or beverages and coffee.
6. To Continue taking Thyronorm and Montair FX.


Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi

Welcome back

I wish her a good health. All the best.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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