Nasal Issues: Symptoms, Concerns, and When to Seek Help

Nasal issues?

Hello, doctor.
I would like to ask about some issues related to my nose.
A month ago, I had a cold, during which I experienced severe nasal discharge.
After that, I had a couple of days with nosebleeds, and I wasn't sure if it was due to constantly blowing my nose.
I also have a slight swelling sensation in my left shoulder, which I had experienced before the cold.
I had a doctor examine it, and they did not find any tumors or anything unusual, but I still feel something is off with my left shoulder.
Additionally, I have noticed that my left eye appears more swollen than my right.
Recently, I came across information about nasopharyngeal cancer and suddenly felt concerned about my unilateral nasal congestion.
I have a history of nasal allergies, and I particularly experience left-sided nasal congestion in the mornings.
This morning, I woke up with a sudden nosebleed, but I do not have any issues with double vision.
After reviewing some information and cases, I feel that my symptoms resemble those of nasopharyngeal cancer, which reportedly does not have very obvious symptoms.
I would like to know how to explain my symptoms to a doctor if I visit a clinic.
Can general clinics perform nasal endoscopy?

Nick, 20~29 year old female. Ask Date: 2009/02/24

Dr. Hu Kexin reply Otolaryngology

Hello, I recommend that you visit a clinic for a consultation.
You can explain to the physician just as you mentioned in your email.
Not all general otolaryngology clinics may have a nasopharyngoscopy available, but most regional teaching hospitals with an otolaryngology department should have this equipment.

Reply Date: 2009/02/24

More Info

When it comes to nasal issues, understanding the symptoms and knowing when to seek help is crucial for effective management and treatment. Based on your description, it seems you have been experiencing a range of symptoms, including severe nasal congestion, occasional nosebleeds, and a feeling of swelling in your left shoulder and eye. These symptoms can be concerning, especially with your recent worries about nasopharyngeal cancer.

Understanding Your Symptoms
1. Nasal Congestion: This can be caused by various factors, including allergies, infections (like a cold), or structural issues within the nasal passages. Given your history of nasal allergies, it's possible that your symptoms are exacerbated by environmental triggers, especially in the morning when allergens may be more concentrated.

2. Nosebleeds: Frequent nosebleeds can occur due to several reasons, including dry air, frequent nose blowing, or irritation from allergies. If you have been blowing your nose frequently due to congestion, this could certainly contribute to the occurrence of nosebleeds.

3. Swelling in the Left Shoulder and Eye: The sensation of swelling in your left shoulder and eye could be related to referred pain or pressure from sinus issues. However, it’s essential to rule out any serious conditions, especially if you notice asymmetry or persistent symptoms.

4. Concerns About Nasopharyngeal Cancer: While your symptoms may align with some signs of nasopharyngeal cancer, such as unilateral nasal congestion and potential swelling, it's important to remember that many benign conditions can present similarly. The absence of other symptoms, such as double vision (diplopia) or significant weight loss, is reassuring.

When to Seek Help
Given your symptoms, it is advisable to consult with an Ear, Nose, and Throat (ENT) specialist. Here are some steps you can take when you visit the doctor:
- Describe Your Symptoms Clearly: When you see the doctor, be prepared to describe your symptoms in detail. Mention the duration of your nasal congestion, the frequency of nosebleeds, and any other associated symptoms like the swelling in your shoulder and eye.
- Discuss Your Medical History: Inform the doctor about your history of allergies and any previous nasal issues. This context can help the physician understand your condition better.

- Ask About Diagnostic Tests: Inquire whether a nasal endoscopy (nasal internal examination) can be performed during your visit. This procedure allows the doctor to visualize the nasal passages and sinuses directly, which can help identify any abnormalities.

- Consider Imaging Studies: Depending on the findings from your examination, the doctor may recommend imaging studies such as a CT scan to evaluate the sinuses and surrounding structures more thoroughly.

Conclusion
In summary, your symptoms warrant a thorough evaluation by an ENT specialist. While your concerns about nasopharyngeal cancer are understandable, many other benign conditions could explain your symptoms. By clearly communicating your experiences and concerns to your healthcare provider, you can work together to determine the underlying cause of your symptoms and develop an appropriate treatment plan. Remember, early intervention is key to managing nasal issues effectively, so don't hesitate to seek help.

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