Suggest Treatment For Severe Throat Pain
I consulted a ENT doctor regarding my throat pain and was diagnosed using Video laryngoscopy, Nasal Endoscopy and CT scan of para nasal sinuses. I have been prescribed medicines based on that for which I needed a second opinion. I have attached images of reports and prescription with this request.
I have been prescribed a broad spectrum antibiotic (ciproflaxin hydrochloride), an antihistamine, nasal spray, drops and multivitamin.
It's been a week since I have been taking the medicines but the pain has not reduced. It's a six month course and I am worried about using antibiotic (especially this one because of its potential side effects) for 6 months.
Kindly provide your opinion on whether these medicines are necessary and sufficient at this time for my condition.
Please see the answer
Hi,thank you for posting your query on health care magic.
I can understand your concern.
I have gone through your reports:
In videolaryngoscopy-the base of tongue seems enlarged.(Base of tongue may get enlarged due to posterior nasal drip from sinusitis,acid reflux,allergies,etc).Movement and appearance of both vocal cords seems normal.Mucous plug is seen over the vocal cord.(Mucous plug over the vocal cord may be seen as a result of drainage from the sinusitis)
In CT Scan Paranasal Sinuses,No gross pathology is seen except Mucosal thickening in the left maxillary sinus and Bilateral Concha bullosa(Air in the middle turbinate bone).(Mucosal thickening occurs in case of sinusitis-inflammation of sinus)
In nasal endoscopy,Bilateral hypertropy(enlargement)of middle and inferior turbinate,purulent discharge around inferior turbinate and mucopus in the nasopharyn is seen.(turbinates are mucosa lined bony shells present inside the nasal cavity.Their mucosal lining may get hypertrophied in case of infection,allergy,etc)(pus is seen around the inferior turbinate and in the nasopharynx is suggestive of bacterial infection in the sinuses).
You might be probably suffering from Bacterial infection in the sinuses(sinusitis) with allergy as an initial event.
Doctor has given you following medicines:
1.)Decongestant Nasal spray containing Xylometazoline.
It helps to reduce the enlarged mucosal lining of the turbinate bones and also helps in drainage of sinus secretions.
2.)Acerbrophylline(mucolytic-causes break down of mucus) with Montelukast and levocetrizine(both are anti-allergic)
3.)Ciprofloxacin-an Antibiotic- it is prescribed for 10 days.
4.)Fluticasone nasal spray-it is a steroid nasal spray-it helps against allergy and is anti-inflammatory-it also helps in reducing the size of enlarged mucosal lining of the turbinates.
As you said ,you have habit of doing smoking sometimes,Cigarette smoke damages and in severe cases destroys the delicate hair-like structures "cilia" found in the sinus membranes which may lead to sinusitis.Cigarette smoke is chronically also irritating to the laryngeal mucosa.
As mentioned earlier by you,that your voice quality is affected and suffering from vocal strain,it is suggestive of chronic laryngitis. It may be caused due to smoking,vocal abuse(speaking in an abnormal pitch like shouting/whispering,or voice over use),Gastro-esophageal reflux,Exposure to irritants like dust and Chronic sinusitis-sinus discharge may irritate the larynx(voice box).
The medications as advised by the Doctor seems appropriate.Antibiotic is given for only 10 days.It will help against the bacterial infection in the sinus.You might start getting improvement after taking the Anti-allergy medication -Montelukast with Levocetrizine,Steroid nasal spray-Fluticasone-after about 2-4 weeks.
In addition,you may get relief by taking Analgesic and anti-inflammatory like Ibuprofen and Antacid like Pantoprazole .
Also take following life-style measures:
Exposure to smoke, strong perfumes and scents, fumes, rapid changes in temperature, and outdoor pollution can be nonspecific triggers in patients with allergic rhinitis. Consider avoidance of these situations or triggers if they seem to aggravate symptoms.
Dust mites in the house is a common cause of allergy.For dust mites, covering the mattress and pillows with impermeable covers helps reduce exposure. Bed linens should be washed every 2 weeks in hot water to kill any mites present. Thorough and efficient vacuum cleaning of carpets and rugs can help.
You can also HEPA filters for your air conditioning units, a dehumidifier (which kills pollen spores and other allergens in the air) and/or an air purifying machine.
Also do steam inhalation. Do warm saline gargles. Avoid cold and very sweet food as they increase mucus production.Drink lots of fluids(warm).Foods with natural antihistamine properties such as garlic, onions, citrus and apples,might also help.
Avoidance of smoking.
Voice rest-for a few days,speak only if it is neccesary.Don't shout or whisper.Take a deep breathe and speak softly.
Hope this answers your question.I would be happy to answer if you have any follow-up questions.Take care.