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Suggest Treatment For Sinus Congestion That Disturbs Sleep Due To Difficulty Breathing

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Posted on Thu, 4 Jun 2015
Question: I am a 76 year old healthy active male. For several months I have noticed sinus congestion that disturbs my sleep due to difficulty breathing thru my nose. I sometimes wake up breathing forcefully thru the nose and sometimes breathing my mouth. Other times I have a peaceful sleep. About 10 days ago I noticed a 3.5*3.5 cm lump just below and slightly forward my ear. It is painless with a slightly numb feeling. My eyes and inner ears itch and I feel a draining sensation at the upper back of my throat when I breath. I am generally comfortable during the day.
doctor
Answered by Dr. Olsi Taka (19 minutes later)
Brief Answer:
Sinusitis seems the cause

Detailed Answer:
I read your question carefully and I understand your concern.

As you yourself seem to suggest, sinus inflammation seems to be the most likely cause to your symptoms of stuffed nose with difficulty breathing, sensation of draining behind your throat. The lump could well be an enlarged lymph node, common in the areas around the infection.

Usually management starts by nasal decongestants to try and facilitate the natural draining of the sinuses. Often oral antihistaminics like desloratadine are added since there is commonly an allergic component to the inflammation.
If those do not seem to work after 7-10 days then antibiotics are used. In your case since you already have symptoms for several months and infection manifestations like enlarged lymph nodes, antibiotics may be started earlier. However since they are prescription drugs and I do not have the possibility of physically examining your ENT (ear-nose-throat) system and the lump that you describe, you should be checked by your primary physician before starting treatment.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (1 hour later)
thank you for quick answer and sound prognosis. ---I will soon meet GP regarding this and am continuing with my own due diligence to be informed when I see him. I feel there is a chance the lump is a parotid gland tumor. Can you describe the differences between a parotid tumor and an enlarged lymph node. The lump I have is about 2-1\4 inches round and 3/4 inch thick----there is no feeling except numbness and it seems to float sideways and up and down about 1/2 inch. It is firm and quite smooth and rounded in all directions.

Sorry for this last question but you know how it is when offered something free.

First time I used this kind of service and am impressed
doctor
Answered by Dr. Olsi Taka (39 minutes later)
Brief Answer:
Read below

Detailed Answer:
Haha I certainly can't point my finger as I can relate to that, I love free stuff as well...and you are of course welcome to ask more questions.

I did think of a parotid gland tumor considering the described location, the reason I didn't mention it is that it didn't explain the rest of your symptoms while an infection - lymph node combination did.
However there are always exceptions, so since I can't examine or have tests ordered on you and it's your health we're dealing with, I recommended the GP visit. Anyway any node over one inch should be carefully evaluated, at times biopsy is necessary.

Parotid gland tumors can be benign or malignant. Malignant forms usually have irregular form and borders, not smooth smooth surface, attached to the surrounding tissue, don't move freely so luckily the lump you describe seems less likely to be a malignant tumor which have a bad prognosis.
Benign tumors can be more difficult to distinguish.
Location is very important in the case of lymph nodes is behind or under the jaw, if the lump is more in front, in the face then tumor is more likely.
Lymph nodes do not generally get that big, but on the other hand benign tumors grow very slowly, so the fact you noticed it only very recently speaks towards a lymph node which can develop quickly.
The smooth regular borders characterize both, lymph node is generally softer. If tender and warm favors lymph node, but it can lack those features.
At times a biopsy is needed to make the diagnosis as I already said.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (26 hours later)
thank you---you have been very thorough and gave me additional insights.
doctor
Answered by Dr. Olsi Taka (5 hours later)
Brief Answer:
Thank you.

Detailed Answer:
Thank you for your appreciative words.
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. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Suggest Treatment For Sinus Congestion That Disturbs Sleep Due To Difficulty Breathing

Brief Answer: Sinusitis seems the cause Detailed Answer: I read your question carefully and I understand your concern. As you yourself seem to suggest, sinus inflammation seems to be the most likely cause to your symptoms of stuffed nose with difficulty breathing, sensation of draining behind your throat. The lump could well be an enlarged lymph node, common in the areas around the infection. Usually management starts by nasal decongestants to try and facilitate the natural draining of the sinuses. Often oral antihistaminics like desloratadine are added since there is commonly an allergic component to the inflammation. If those do not seem to work after 7-10 days then antibiotics are used. In your case since you already have symptoms for several months and infection manifestations like enlarged lymph nodes, antibiotics may be started earlier. However since they are prescription drugs and I do not have the possibility of physically examining your ENT (ear-nose-throat) system and the lump that you describe, you should be checked by your primary physician before starting treatment. I remain at your disposal for further questions.