Hi,

Thanks for the query

The symptoms you perceive could be either due to vasomotor rhinitis or Allergic rhinitis.

With regards to the CT scan the sinuses are clear, which indicates any infection of the sinuses. So the most probable cause could be either vasomotor rhinitis or allergic rhinitis. Both of the above two conditions present in a similar fashion, the exception being vasomotor rhinitis, which is due to non-allergic condition of the nose.

The infection in the nostril could be due to the dryness of the nose following the cold climate in England. Similarly, the sore throat is also because of the same problem. Due to stuffiness of the nose, the nostrils get blocked and you tend to breathe through the mouth. Mouth breathing and the prevailing chill weather, causes dryness of the throat, which will further worsen the problems and leads to throat discomfort.

My suggestion to you is to drink plenty of warm water and use saline nasal spray 3-4 times a day (to keep the nasal mucosa moist and decongest the nose), followed by steam inhalation. Also, you will require medicines such as steroid nasal spray (such as fluticasone or momentasone), an antihistaminic such as fexofenadine or cetrizine for few days and oral steroids for 2-3 days. Avoid chilled beverages, coffee and smoking if any.

Regarding burning sensation on the tongue and metallic taste in the mouth, these symptoms are the side effects of the medicines you are taking.

Please consult your doctor at the earliest and get treated accordingly.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

---

Hi

Thanks for writing back

To explain to you in detail, due to long standing nasal congestion (allergy or vasomotor problem) and nasal block, there can be negative pressure developed behind the obstruction causing blockage of the sinus opening, leading to stagnation of the secretions. Stagnated secretions get infected giving rise to various symptoms.

Long standing (chronic sinusitis) nasal block produces symptoms such as nasal congestion, facial pain, headache, night-time coughing, thick discharge, feeling of facial 'fullness' or 'tightness' that may worsen when bending over.

Generally, the bacteria noticed during sinus infection is streptococcus pneumoniae (also called pneumococcal pneumonia or pneumococci), which is found in 20% of adults and 43% of children with sinusitis. This is followed by H. infuenzae and staphylococcus aureus (6% of adult cases).

Q: But it constantly drains and I am constantly having to clear my throat of its XXXXXXX drainage".
A: In chronic sinusitis there is post nasal discharge draining from the behind the nose into the throat which will be causing throat discomfort, repeated hawking and cough.

Q: Also, was wondering could I possibly have staph of the sinuses? What are the symptoms of staph of the sinuses if that is such a thing?
A: There could be the presence of staphylococcal organisms in the nose causing sinusitis, which can be confirmed with the swab taken from the nose and sent to lab for culture and sensitivity. The symptoms of all the bacterial sinusitis are similar as I mentioned above. It does not vary with the type of bacteria invloved.

Q: Which medications are giving me the symptoms?
A: Topomax can cause recurrent upper Lyrica and Opana.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

---