Hi

Thanks for the query

The symptoms you have described are the features of Seasonal Allergic Rhinosinusitis.

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

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 pollen, dust, fumes, coils smoke, etc. are the common triggers of allergy. 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.

If the sinuses are blocked, you will definitely require surgical intervention in order to clear the block. But, after surgery you will have to switch on to the preventive measures and use steroid spray for at least six months.

Before getting operated you need to get a CT scan of the paranasal sinuses done to assess the amount of block and study the anatomy of the nose and paranasal sinuses.

High cholesterol is not a contraindication for surgery.

For the time being you can try the following:
1. To use steroid (such as Momentasone/ Fluticasone) nasal spray once a day, this reduces nasal allergy and itching in the eyes.
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. Use a mucolytic such as Bromhexine and Ambroxol, this helps in thinning of the tenacious secretions.
4. An antihistaminic such as fexofenadine /cetrizine/loratidine taken will reduce the allergic problems.
5. Drink plenty of warm water and to avoid chilled food or beverages and coffee.
6. Avoid smoking/coffee if any
7. Cover your nose and mouth with a clean cloth (or wear a mask) when exposure to dust or smoke is imminent.
8. Consult a good ENT specialist for a thorough examination and further management.

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 XXXXXXX

Welcome back and thanks for a detailed explanation.

All your symptoms are suggestive of Seasonal Allergic Rhinosinusitis. The relief in pain following pressure over the jaw is due to suppression of the trigeminal nerve supplying the face.

First of all consult a good ENT specialist at your place, ask for a CT scan of the nose and paranasal sinuses. After seeing the report plan for further management. Meanwhile follow the measures mentioned in my previous response. Once you get a CT scan, mail the images to me, I will guide you accordingly.

I wish you good health.

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

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