Could the nasal allergy be indicative of rhinitis?

Question

Hello doctor,

I have nasal allergies, which can trigger sneezing and a runny nose, along with sneezing when I come in contact with dust. However, I constantly have thick post-nasal drip mucus that covers my vocal cords and makes my voice very weak all the time. My nose has not felt 100 % open in years. Also, I have trouble hearing because of trapped fluid in my ears. Does this mean I could have rhinitis on top of my allergies? I am a singer and used to have a thunderous, resonant voice, and now I struggle to achieve even a portion of that resonance. Currently, I am doing a saline cleanse. Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your symptoms point towards chronic rhinosinusitis superimposed or worsened by an allergy. This can explain all symptoms. Singers are more troubled by this condition because they require clear sinonasal cavities for good voice and resonance. I suggest you do some investigations and I will tell you why. Complete blood count to detect any infection. Total serum IgE to check for allergy (type 1 hypersensitivity or atopy). Non-contrast CT (computed tomography) scan of paranasal sinuses to check for sinus inflammation, fungus, or any other condition inside sinuses causing constant mucus secretion and post-nasal drip. A laryngoscopy can also be done to illuminate the vocal cord and understand if there is any local pathology in the vocal cord secondary to the sinus disease or de novo.

I suggest you start the following medicines. An intranasal steroid spray is to be taken twice daily in each nasal cavity. An antihistaminic with a Montelukast combination was taken once daily. A mucolite medicine is used to help lighten the mucus and bring it out better. An antacid medicine like Protonix (Pantoprazole) reduces acid secretion in the stomach and also reflux laryngitis. Lastly, some dietary and lifestyle modifications will also be required. Desist from gargles and steam inhalation.

I hope this helps.

Please revert so I can assist you further.

Thank you.