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A 54-year-old female presents with 3 years of bilateral nasal congestion. She describes this as trouble breathing through her nose. Her nasal congestion can occur on both sides of her nose and often alternates. She sometimes has thin, clear, nasal drainage from both nostrils and mild decrease in sense of smell. She has not noticed any particular pattern or seasonality to her symptoms..

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Please use the discussion feature below to ask the authors your questions and provide further feedback on others’ questions. All questions and replies are moderated.


  1. James Murdocco MD

    After decongesting the nasal mucosa, examine the nose, then decide where you from there.

  2. Pshdar Waisi

    Respond for high dose steroid treatment nasally and systematically…

  3. Dr. Waleed Basha

    Needs CT scan nose and paranasal sinuses without contrast .

  4. HeXueCheng

    Q1 Does the patient need to open mouth to breathe?
    Q2 Does the patient have post nasal drip?
    Q3 Could you, please provide more details about the patient’s olfactory?
    Q4 Could you please offer the patient’s medication history?

  5. luping zhang

    CRS with nasal polyps

  6. Francesco Antonio Salzano

    Has the patient been offered an in-depth assessment of the nasal microbiota and the function of the trigeminal system with identification of the nasal tactil sensitivity threshold?


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