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Sinus pressure causing cloudy thinking, breathing difficulty, saliva choking, throat dryness, frequent urination. Test results normal. Reason?

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ENT Specialist
Practicing since : 1991
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I regularly have sinus pressure leading to very cloudy disjointed thinking. Breathing through my nose is not easy, my nostrils flair in. It helps if I pull up my nose a bit with my fingers. I have lately been snoring and choking on my saliva.

Once every other week I will have a day of SEVERE misery –talking is unpleasant, my throat is dry and tight, I am short of breath, I have trouble swallowing, my heart beat feels either raised or just more noticeable, and weirdly have to urinate frequently (my urine is quite yellow then despite adequate hydration).

In Nov, blood work only revealed a B12 and D deficiency. I visited an urgent care unit in February for heart worries – the chest xray and EKG found nothing. I went to an ENT walk-in clinic and the doctor looked up my nose but didn’t see anything unusual – I wasn’t experiencing symptoms at that time though. I sometimes use Mucinex D or Anefrin nasal spray which have questionable results.
Posted Mon, 3 Jun 2013 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 8 hours later

Thank you for your query.

1. What you describe are common symptoms of chronic nasal obstruction.

2. Get a plain CT PNS (Para Nasal Sinuses) done on a multi-slice CT Scan machine. This may be done pre and post decongestion with xylometazoline nasal drops. There should be 1 mm cuts in the coronal, axial and saggital planes. This CT scan will settle the issue whether you have sinusitis or not and where the nasal obstruction exists. You may share the images here for an accurate assessment.

3. Nasal turbinate hypertrophy can lead to nasal obstruction besides septal deviations and nasal valve problems. Radio-frequency ablation, coagulation and balloon sinuplasty are new options to traditional sinus surgery.

4. You may also be suffering from Rhinitis Medicamentosa due to long term use of Mucinex D and Anefrin nasal spray.

5. Other commonly associated conditions such as a post nasal drip, acid reflux, drug related side effects, anxiety and vitamin and mineral deficiencies add to the misery. These must be identified (such as your vitamin B12, D) and possibly calcium deficiency. Urine would be yellow if you are on vitamin B complex supplements. Otherwise it is better to get the urine examined.

6. I recommend that you take a trial of medication for two weeks with an anti-allergic, anti-leukotriene, steroid nasal spray and regular steam inhalation before any surgical treatment.

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

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