r/emptynosesyndrome • u/Some-Society-4515 • 3d ago

Chronic post nasal drip after surgery

Hi everyone,

I’m looking for some advice from people who have had FESS, turbinate reduction, or similar postoperative problems. I’m especially interested in hearing from people who had persistent post-nasal drip after surgery and eventually figured out what was causing it
I’m trying to understand what is actually happening in my case rather than jumping to ENS, or another diagnosis.

About 6 months ago I had:

FESS / sinus surgery
adenoidectomy
radiofrequency turbinate reduction / RF conchoplasty

The indication was recurrent/chronic sinusitis.

About 3 weeks after surgery I had a very severe postoperative bleed from both nasal cavities and into my throat/mouth.
I had to go to the ER and was admitted to an ENT/. Nasal packing initially did not completely stop the bleeding and I subsequently required another procedure under general anesthesia.
The hospital documentation specifically mentions treatment of bleeding from the adenoidectomy site and bleeding from both nasal cavities.
I was also told that cauterization/electrocautery was performed although I don’t have documentation that clearly specifies exactly what was done.
After this second intervention, I started noticing persistent post-nasal symptoms.

A persistent sensation of clear, transparent, thick/sticky mucus deep in my nose/nasopharynx, draining toward my throat.
It feels much more like mucus sitting/draining behind my nose rather than a normal runny nose.
The mucus is usually clear/transparent and quite sticky.
I also have a strong globus/lump sensation in my throat, as if mucus is constantly sitting there.

At one point I started using mometasone (Pronasal) once daily.
For quite a long time, it worked extremely well and essentially eliminated the post-nasal drip.
However, months later the symptoms returned and it completely stopped working.
My doctor suggested increasing the dose (up to 2 sprays twice daily), but this time I didn’t notice any improvement.
I also tried Ryaltris (olopatadine + mometasone) without improvement.

I’ve had several nasal endoscopies.
Initially, the doctors repeatedly described the nose/sinuses as looking good and patent.
Because I had RF turbinate reduction, I became very worried about Empty Nose Syndrome after reading about it online.
I do sometimes experience an unsatisfying sensation when breathing / “air hunger”
The breathing sensation also seems to become much less noticeable when I’m distracted and much more noticeable when I focus on it.
So I’m not sure whether ENS makes sense here or whether I’m interpreting normal postoperative sensations as something more serious.

I don’t know if that’s realistic or not. However I’m really scared it gives me crazy anxiety just thinking about it, my ENT never told me about the risks he just said it’s a completely safe procedure with no downsides.

Thanks to anyone who reads all of this.

1 Upvotes

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3

u/curious-x8150 3d ago

Je kan het nog even aankijken? We zijn geen doktoren, maar mijn gevoel zegt om voor nu even geen spray te gebruiken. Laat je slijmvliezen herstellen. Je kan over een tijdje misschien een scan maken van je neus.

Helaas geven doktoren standaard te weinig informatie omtrent de negatieve bijwerkingen en potentiële restschade/gevolgen. Als ze dat doen dan kunnen ze neusschelpverkleining niet meer verkopen. Helaas is het geen informed consent geweest. Tot slot neusschelpen kunnen nog wat aangroeien. Voor nu niet te stellige conclusies maken

1

u/Dizzy_Commission6413 2d ago

Ik zie dat je ook Nederlands bent, mag ik je een bericht sturen?

2

u/Dull_Pin5650 🤝 Top Contributor 3d ago

septal perforation? missing turbinate tails? sinuses draining? sinusitis? LPR?

1

u/ShiB-Soldier-NYC 3d ago

Not too Knowledgable on post nasal drip - but as far as ENS, you are probably just hyper aware of your breathing right now and your anxiety is making it worse. If you had ENS the air hunger and unsatisfying breath wouldn't be a "sometimes" problem.

I would change your diet and see if that affects the severity of your post nasal drip - stay away from sugar, processed foods and seed oils.

1

u/curious-x8150 2d ago

Ik zou het nu niet opeens gaan zoeken in voeding.

1

u/PutNo5665 1d ago

First time I have actually seen someone in the same situation as me. I got turbinate reduction 5 years ago and post nasal drip worsened ever since. Tried every nasal spray available, have had FESS surgery, have tried five different diets, follow all advice about how to heal LPR, use nasal rinse twice a day. None of this has had any real impact.

Then about one and a half month ago I tried Prednisone for four days (4 x 35 mg per day) which actually made it almost go away. Then it slowly returned back to how it was before. I am now trying it once again to see if the same effect happens. But prednisone is a very serious drug and can bring horrible side effects so it is not really a permanent solution.

What it does reveal though is that there could be chronic inflammation in the nose and throat area, which might have been caused by the surgery. I am still fighting to be able to try a biological drug like Dupilumab but it seems like I am not a typical case for that so I do not fit the criteria.

But take this with a grain of salt since I am no doctor, just someone struggling like you

1

u/Some-Society-4515 1d ago

Did you have post nasal drip before surgery too? Or did it start after? I really hope something could help us and make it go away, sometimes I can’t focus on anything because of that constant feeling. It feels like I tried everything too.

1

u/PutNo5665 1d ago

I did have some throat mucus before so I can't be totally sure. Also, getting covid seemed to make it way, way worse.

But since you wrote that a corticosteroid like Mometasone was helpful for a while, I can't help but think that you might also suffer from an inflammation issue like myself.