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What Causes Bad Odor From The Nose While Suffering From Nasal Congestion?

Posted on Thu, 20 Oct 2016

Question: Respected Sir,

I have been having nasal congestion sometimes in a day for last 30 years and having bad smell while sneezing for last 2 years.
Already tried taking anti-allergic, anti-biotic and Nasal sprays.
As per ENT Doctors advise,
I had CT PNS coronal plain scan.Doctor says that Laparoscopy / Endoscopic surgery required to recover from these problems.

Kindly take a look at the result mentioned below and explain
1. Please explain in detail what are the problems identified along with reason behind them and advise what are the treatment options available for all the problems identified.
2. Can it be fixed without surgery ? If yes, please advise the treatment option.

CT PNS Result :
----------------
Serial 5 mm axial & coronal section of PNS was obtained.
Bilateral frontal, sphenoid and ethmoid sinuses are normal.
There is diffuse mucosal thickening noted in left maxillary sinus.
Bilateral asteomeatal complex are normal.
Mild DNS noted to right side with hypertrophied left inferior turbinate.
Bony walls are normal.

IMPRESSION:
Chronic left maxillary sinusitis.
Mild DNS to right side with hypertrophied left inferior turbinate.

Many Thanks in advance.

Answered by Dr. Prasanna Heijebu (9 hours later)

Brief Answer:
Surgery is the only treatment plan

Detailed Answer:
Hello Sir

I can certainly understand your concern.

I have worked through your query in detail.

Chronic left maxillary sinusitis along with Mild DNS with hypertrophic inferior turbinate can be treated ONLY through surgery.

Medical management through drugs is impossible.

There is an obstruction to the passage of fluids in the sinuses secondry to obstruction caused by diffuse mucosal thickening and dental deviation in the nose.

Hence surgery is the only way to relieve these issues.

Septoplasty with functional endoscopic sinus surgery are the surgeries of choice.

Post your further questions if any.
Thank you.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Prasanna Heijebu (3 hours later)

Thanks for prompt response/answer and providing valuable information/suggestion.

I remember 30 years back I got injured near nose at right side while walking on road. May be that resulted in a deviated septum. For which I am having difficulty with breathing. Is my understanding correct. Please confirm .

I could not clarify about 'diffuse mucosal thickening'. What is it about and what may have caused it in may case. Could you please explain

Also as mentioned before, I sneeze smells bad for last two years. ENT says it is because pus in sinus. Will it be gone after the surgery or need any medical management ? Please comment
Could you please update on my questions. Please let me know if I asked wrong questions in case.

Also please let me know if I skip the surgical treatment, will there be any issue in future ?

Many Thanks in Advance.

Many Thanks in Advance.

Answered by Dr. Prasanna Heijebu (34 hours later)

Brief Answer:
Surgery is advisable to cure all symptoms

Detailed Answer:
Hello Sir

Yes, trauma to nose possibly resulted in DNS.

Diffuse mucosal thickening is a response shown by sinuses due to long term obstruction to the flow of fluid from sinuses to nose and back of throat.

The bad smell is because of super added infection in the sinuses .

All the above are treated by surgery alone.

Medications play only supportive role.

In case if you skip surgical procedure, there is a risk if speaking of infection to brain and future hearing defects.

Post your further questions if any.
Thank you.

Above answer was peer-reviewed by : Dr. Raju A.T