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Suggest treatment for blocked nasal passage

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Posted on Tue, 19 May 2015
Question: My son( 18 yrs) is suffering from blocked right nose passage for last 20 days, I have consulted one ENT surgeon, Doctor was suspecting a polyp in right nose passage, x-ray report revealed that right maxilliary antrum hazy and plucosal polyp in left maxilliary antrum. Doctor has prescribed Alfro Nasal Spray, Tab Ivepred(20mg) and Ketasma for fifteen days. My son had to undergo three operation from the age of 12yrs for dental odontogenic keratocyst, as per dentist this kind of cyst recurrence rate is very high may come again any places in mandible and maxilla region till 20-22yrs of age. Last operation was done about more than one year back. Coming back to the present problem. Can polyp or cyst be detected by x-ray. There is no external swelling and blood discharge from blocked nose except some normal discharge due to cough and cold. Is there any chance of keratocyst to enter into sinus area and shows hazy, although x-ray report showing polyp in left but only right nose is blocked, requesting your valuable opinion in this regard.
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Answered by Dr. Nishad BN (37 minutes later)
Brief Answer:
Can see polyp or cyst but there is limitations.

Detailed Answer:
Hi

Thank you for asking HCM.

I have gone through your query. It is possible to see the shadow of polyp or cyst by x ray. But there is only limited information we can get from that. If further information is needed a CT or MRI should be performed.

Such polyps can block the sinus drainage and cause sinusitis which gives sinus a hazy appearance on x ray. In such case endoscopic study will help to get information. Excision of cyst and drainage of sinus can be performed though that also.
A consultation with a dentist also should be done to rule out any possibility of recurrence of odontogenic keratocyst. It rarely appears in maxilla. Usual appearance is in mandibular area. But in case of appearing in maxillary region there is possibility of extension towards maxillary sinus. It can give hazy appearance of sinus also. But usually can differentiate such hazyness in X ray itself. A CT or MRI will give more information in case of inconsistency.

Regarding your last question: Here your right maxillary sinus hazy which give signs of right maxillary sinusitis. This can be the reason of right nasal block. Left sided polyp is not a cause of this block. May be your polyp on left side doesn't block the left sinus drainage. Endoscopy will give an accurate picture for all of these.

Hope this may help you. Let me know if anything not clear.
Thanks.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Dr. Nishad BN

General & Family Physician

Practicing since :2009

Answered : 5363 Questions

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Suggest treatment for blocked nasal passage

Brief Answer: Can see polyp or cyst but there is limitations. Detailed Answer: Hi Thank you for asking HCM. I have gone through your query. It is possible to see the shadow of polyp or cyst by x ray. But there is only limited information we can get from that. If further information is needed a CT or MRI should be performed. Such polyps can block the sinus drainage and cause sinusitis which gives sinus a hazy appearance on x ray. In such case endoscopic study will help to get information. Excision of cyst and drainage of sinus can be performed though that also. A consultation with a dentist also should be done to rule out any possibility of recurrence of odontogenic keratocyst. It rarely appears in maxilla. Usual appearance is in mandibular area. But in case of appearing in maxillary region there is possibility of extension towards maxillary sinus. It can give hazy appearance of sinus also. But usually can differentiate such hazyness in X ray itself. A CT or MRI will give more information in case of inconsistency. Regarding your last question: Here your right maxillary sinus hazy which give signs of right maxillary sinusitis. This can be the reason of right nasal block. Left sided polyp is not a cause of this block. May be your polyp on left side doesn't block the left sinus drainage. Endoscopy will give an accurate picture for all of these. Hope this may help you. Let me know if anything not clear. Thanks.