FAQs – Nose Conditions

 

Q. I heard using steroids in the long term is bad for health. Is there a problem using nasal steroid spray for a long time?

A: Taking oral steroids in the long-term is associated with complications. However, there are no long-term complications associated with the use of nasal steroid sprays such as Nasonex, Flixonase as very little (less than 1%) of the active ingredient (steroid) actually gets into the blood system. Studies have also shown that it is safe to use nasal steroid sprays in children.

Q: I’m allergic to house dust mites. What are the ways I can get my room house dust mite free?

A: House dust mites are found just about everywhere. It is estimated that in one queen size bed, there are 10 million mites living with you. Hence, it is nearly impossible to have a room dust mite free. There is a mite killer called Acardust which comes in the form of a spray. This can be applied to the beddings, carpets, blankets etc and serves to kill the mites in them. It needs to be applied on a monthly basis. The use of air-purifiers, ionizers etc have little effect on the houst dust mite population as does sunning mattresses or washing lining in hot water or beating mattresses.

Q: I get persistent yellowish discharge from my nose. It improves with antibiotics but soon recurs after the medications finish. What should I do?

A: It sounds as if you have chronic or recurrent sinusitis, or infection of the sinuses. If the problem persists for more than 3 months, or has more than 3 episodes of sinusitis a year, a CT scan of the sinuses is indicated to determine the extent of infection. Depending on the CT scan report, endoscopic sinus surgery may be required to clear infection and restore function of the sinuses.

Q: My nose is always blocked. It makes me feel uncomfortable, affects my sleep and causes a headache. What can be done?

A: Nasal blockage can be due to enlarged turbinates, infection or growths in the nose. Enlarged turbinates can be treated with radiofrequency application (see Radiofrequency Turbinate Reduction under Commonly performed clinic procedures). Infections should be treated with an appropriate course and dose of antibiotics. Tumors are confirmed on biopsy and treatment depends on the type and extent of disease.

Q: My cheeks and forehead hurts every time I fly. Could it be due to my sinus problem?

A: Flying results in changes in atmospheric pressure. Sinuses are closed spaces within the skull and the openings of the sinuses are usually millimeters wide. If the openings are narrowed further by allergies or infection, then patients feel the changes in atmospheric pressures more acutely during flying or diving. Topical antidecongestants usually afford effective relief of symptoms.

Q: Is there a cure for my sensitive nose?

A: Nasal sensitivity as a result of allergy is a genetic condition and hence, strictly not curable. However, there is a form of treatment called Immunotherapy (see Immunotherapy) which alters the immune system’s response to allergens so that the patient does not experience the symptoms of allergy when exposed to allergens.

Q: My child constantly rubs his nose and eyes and the nose sometimes bleeds. He says it’s itchy and is associated with runny nose. What can be done?

A: Many patients with nasal allergies rub the nose because histamine release as a result of allergen exposure, causes itchiness as a result of inflammation and swelling. Bleeding is common in poorly-controlled allergies because of the trauma associated with rubbing and sneezing. There are many medications that give good control of such symptoms. Antihistamines such as Clarityne, Aerius, Telfast, Xyzal, Zrytec etc are good and non-sedating. Eye drops such as Patanol target eye symptoms.

If you like to pose a question to Dr Chee, please email him at gchee@gcheeent.com and he’ll get back to you within one to two days (unless it’s the weekend).

Dr Gerard Chee

MBBS (S'pore), FRCS (Edin), FRCS (Glasg) Fellow, Otology / Neurotology (Can)

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