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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Hole In The Nose Compromising Post Nasal Drip And Cough?

i have been having extreme crusting in the nose and my ENT has found a hole developing. I have been going through this for 7 months and it is painful, compromises my breathing, causes post nasal drip and a lot of coughing and over all maliaise. My next appiontment is this Friday. Is there anything you can recommend I tell my doctor. I have not gotten any positive information and the only treatment has been nasal antibiotic which isn t doing anything and saline rinses several times per day. Please help I am 5 11 and 20 lbs I have relapsing remitting ms for 25 years being treated with Tysabri for last 2 years. Multiple symptoms like optic nueritis, overactive bladder, foot drop, extreme fatigue, and deppression. I am currently stable according to last mri. Mike
Thu, 28 May 2020
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General Surgeon 's  Response
Hi,

Noted your history about having recurrent MS for 25 years, being treated with Tysabri, have multiple problems like optic neuritis, overactive bladder, foot drop, extreme fatigue, and depression, ENT has developed perforation in nose, painful crusting of nose, breathing difficulty and so on which is your main query.
Your nasal symptoms are suggestive of a condition called ''Atrophic
Rhinitis''.
You are already under god treatment of nasal washes, antibiotics and so on.
The perforation is due to the same condition.
Further management can be as follows to be discussed with your Doctor, particularly an ENT Surgeon.
Oral Iron therapy.
Multivitamins with mineral and trace elements act as anti-oxidants.
Closing one nostril surgically for one year helps for recovery in some cases.
Oral antibiotic therapy when needed.
Soda-bicarb nasal washes.
And anything else as your ENT Would suggest.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. T. Chandrakant, ENT and General Surgeon
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What Causes Hole In The Nose Compromising Post Nasal Drip And Cough?

Hi, Noted your history about having recurrent MS for 25 years, being treated with Tysabri, have multiple problems like optic neuritis, overactive bladder, foot drop, extreme fatigue, and depression, ENT has developed perforation in nose, painful crusting of nose, breathing difficulty and so on which is your main query. Your nasal symptoms are suggestive of a condition called Atrophic Rhinitis . You are already under god treatment of nasal washes, antibiotics and so on. The perforation is due to the same condition. Further management can be as follows to be discussed with your Doctor, particularly an ENT Surgeon. Oral Iron therapy. Multivitamins with mineral and trace elements act as anti-oxidants. Closing one nostril surgically for one year helps for recovery in some cases. Oral antibiotic therapy when needed. Soda-bicarb nasal washes. And anything else as your ENT Would suggest. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, ENT and General Surgeon