I have had the sensation of scratchiness and like something is aggravating my soft palate. I have also had episodes of mild vertigo over the last few years. A CT scan of the IAC and head was done and revealed no abnormalities. An ENT and two internal medicine doctors have looked down my throat and can see nothing even though I tell them that something appears to be aggravating and scratchy from the base of my eustachian tube to the back of my throat on the right side. I have also had some ear discomfort that I am not sure I did not cause by holding my nose and blowing to stop whatever is there. I can minimize the symptoms momentarily by humming low notes . I have also tried to look behind the arch in my mouth but have only caused myself to gag . My ENT did a scope from nose to larynx which revealed that my right soft palate had mucous on it and it was irritated. I have been given three cortisone shots in my buttocks, and have been orally given allegra, zithromax, and vancenase and nasocort sprays. I also tried to gargle salt water which I swallowed and tthrew up. As you can see I am open to any remedies. The symptoms are still here. They say I have nasopharyngitis. I can't help but wonder if ther is something else I could do to get some relief. I always fear that something more could be wrong since many times things go unnoticed until they are in advanced stages. My paranoia and worry make me feel like I am crazy for saying I feel something they can't see. However I know what I feel and if they don't fix me I may go crazy. Try breathing, swallowing, drinking, and eating while trying to avoid thinking about something that we do all day long. All lab work including a SMAC was normal. Please help with any information or remedies to make this aggravation stop.
Reply: -------------------------
It would appear that you are suffering from a localized inflammatory (possibly allergic) process affecting an area in your nasopharynx. It would also appear that you have had an extensive evaluation including CT scanning and endoscopy. It might be reasonable to consider an allergy evaluation if it has not already been done. It is possible that a specific cause for the problem may not be found, but you should rest assured that serious problems such as a malignancy would not elude endoscopic or radiographic identification for very long and most certainly not for as long as you have experienced your symptoms. As far as medications that might be recommended for this type of symptom, nasal steroids (Beconase, Flonase, Vancenase, Rhinocort, etc) would be expected to have the greatest potential benefit - to give them a reasonable trial they would need to be used daily over several weeks before concluding that they were ineffective. There is also a new antihistamine spray (Astelin) that might be helpful. However, you might find that nasal irrigation offers the most benefit - I would specifically suggest a trial of daily pulsatile nasal irrigation with a dilute salt water solution using a Grossan nasal irrigating tip which is attached to a Water Pik. Your otolaryngologist should be able to order the Grossan irrigation tip or perhaps a local pharmacy can obtain one for you.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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