Managing Nasal Conditions: Deviated Septum, Polyps, and Sinusitis - Otolaryngology

More Info

---

Managing nasal conditions such as a deviated septum, nasal polyps, and sinusitis can be quite complex, especially when there are overlapping symptoms and previous treatments that may not have yielded the desired results. Based on your description, it seems you have been dealing with a combination of issues that include acute sinusitis, potential chronic sinusitis, and a deviated septum, which can all contribute to your symptoms of nasal congestion, post-nasal drip, and dizziness.


Understanding Your Conditions
1. Deviated Septum: This is a common condition where the nasal septum, the cartilage and bone that divide the nasal cavity, is displaced to one side. This can lead to chronic nasal obstruction, difficulty breathing through the nose, and can contribute to sinus infections. If the deviation is significant, it may warrant surgical intervention (septoplasty) to correct it.

2. Nasal Polyps: These are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses that can result from chronic inflammation due to conditions like asthma, recurring infection, allergies, drug sensitivity, or certain immune disorders. They can block nasal passages and sinuses, leading to difficulty breathing, loss of smell, and sinus infections.

3. Sinusitis: This refers to inflammation of the sinuses, which can be acute or chronic. Acute sinusitis often follows a cold and can cause symptoms like facial pain, nasal congestion, and thick nasal discharge. Chronic sinusitis lasts longer (more than 12 weeks) and can lead to persistent symptoms that significantly affect quality of life.


Your Symptoms and Previous Treatments
You mentioned experiencing dizziness and post-nasal drip after a cold, which can be indicative of ongoing sinus issues. The fact that you had acute sinusitis diagnosed during your military service and were treated with medication suggests that your nasal passages may still be inflamed or obstructed, leading to chronic symptoms.

The treatment you received from traditional Chinese medicine (TCM) involving cauterization of the nasal mucosa may have had mixed results. While some patients report relief from symptoms, others may experience complications or worsening of their condition. The concern about needing to wait for three months before considering surgery is valid; the nasal mucosa needs to heal properly to avoid complications during surgical procedures.


Recommendations for Management
1. Follow-Up with an ENT Specialist: Since you have a history of nasal issues and have undergone various treatments, it would be beneficial to consult an Ear, Nose, and Throat (ENT) specialist. They can perform a thorough examination, possibly including nasal endoscopy, to assess the current state of your nasal passages and sinuses.

2. Imaging Studies: A CT scan of the sinuses may be recommended to evaluate for chronic sinusitis, the presence of polyps, or the degree of deviation of the septum. This imaging can provide valuable information for planning any surgical interventions.

3. Medical Management: If you are diagnosed with chronic sinusitis or nasal polyps, medical management may include nasal corticosteroids to reduce inflammation, saline nasal irrigation to keep the nasal passages moist, and possibly antibiotics if there is a bacterial infection.
4. Surgical Options: If conservative treatments do not provide relief, surgical options such as septoplasty (for the deviated septum) and functional endoscopic sinus surgery (FESS) for chronic sinusitis or polyps may be considered. These procedures can help restore normal airflow and drainage from the sinuses.

5. Lifestyle Modifications: Staying hydrated, using a humidifier, avoiding known allergens, and practicing good nasal hygiene can also help manage symptoms.


Conclusion
Managing nasal conditions requires a comprehensive approach that considers the interplay between structural issues (like a deviated septum), inflammatory conditions (like sinusitis), and any previous treatments. It is crucial to work closely with healthcare professionals who can guide you through the appropriate diagnostic and therapeutic pathways. By addressing these issues systematically, you can improve your quality of life and reduce the frequency and severity of your symptoms.