I am an 28 yer healthy male who unfortunately abused Otrivine (oxymetazoline nasal drops) for a period of 12 months so as to fight my night time nasal congestion
The last 7 months one of my nostrils is almost completely blocked-the blocked nostril is alternating and I feel pressure on that side. The blockage is there only when I lie down or sit, the blocked nostril opens up when I excercise, run, walk briskly. Why?
I visited many good ENTs. The problem was obvious: enlarged (swollen) turbinates. No nasal discharge and prich test negative so the docs said vasomotor rhinitis
Initially we thought rhinitis medicamentosa. I stopped the oxymetaz. nasal drops and used Nasonex (steroid sspray) and Xozal antohistamine. Neither helped. I switched to Pulmicort/Flexotide steroids -NO relief. Saline just helped with the dryness. Tapered Oral steroids (prednisone) also tried. Very small temporary relief
Being a very active and decisive young man I tried to resolve the situation as soon as possible
-Did a CT scan of the sinuses ALL CLEAR, turbinate shape not abnormal, septum very mildly deviated
-Had ***** tests all negative, IgE within normal range
-Had antibody tests against all usual viruses (from HIV to CMV) everything OK
-Had a mucosa sample taken-nothing uncommon
-Had blood count tests-eosinophils were double the normal count but these eventually dropped, the problem was reduced but NOT resolved-the blockage is still there
The only drug that does temporarily help is a nasal spray called Dexarhina (german product which we have in Greece where I live). It has decongestant (so bad due to the rebound) and a steroid put together.
My doctor mentioned Radiofrequency Surgical Turbinate Reduction, to resolve the issue. I am very concerned about:
1) Is what I have typical vasomotor rhinitis? Why can't it resolve with drugs ?(or the problem is that I can't live without drugs...as the congestion comes back)
2) I would like to avoid Radiofreq surgery due to the so called Empty Nose Syndrome ( removed ). Is my fear well-founded? Should I really worry?
3) I (paradoxically) tend to believe I need surgery-otherwise the problem will not resolve. Do you agree with that?
Last edited by moderator2; 07-13-2008 at 10:04 AM.
Reason: too much white space, posted disallowed website
First of all, if what you have is Vasomotor rhinitis, it can be tough to find an effective medical treatment regimen (because by definition it's non-allergic). You're mostly stuck trying to manage the symptoms instead of the underlying problem.
You never mention oral decongestants like pseudoephedrine - that's the first thing I would try because it can reduce the congestion and doesn't cause the rebound swelling (and I worry that any nasal spray that causes rebound swelling is going to do you more damage than good).
There are lots of different nasal steroid sprays - you may have to try them all before you find one that works, but keep trying.
Finally, on the surgery front, turbinate reduction can be done safely with minimal risk of ENS when it's done very conservatively by a doctor who is familiar with the risks of removing too much tissue. I don't know whether the radio frequency method is better than others but I suspect if you find the right doctor he or she will be able to reduce the swelling without much risk.