Matthew Vajen, DO

A perforation is possible. These typically heal on their own in a few weeks to months. A microscopic ear exam by an ENT can verify this.

Matthew Vajen

The soreness and crusting may be due to nasal vestibulitis. This is typically treated with an antibiotic ointment such as mupirocin. See your local ent for management.

Your symptoms are likely related to an anatomical issue with the nose. The cycle you describe of one nostril opening and the other closing is part of the natural swelling cycle of the turbinates. However, if your turbinates are too big for your nose, it can cause obstruction. An exam by an ENT with a nasal scope can give you a better idea of possible nasal abnormalities contributing. Other factors could be nasal polyps, deviated nasal septum, or nasal valve collapse.

While these symptoms can be caused by a variety of disease processes, it most likely is laryngopharyngeal reflux (LPR). LPR is a variation of gastroesophageal reflux disease (GERD) that affects your upper airway. Typical symptoms include a sensation of a lump in the throat, chronic throat clearing, heartburn/chest pain, chronic cough (especially nighttime cough), laryngospasm (vocal cords spasm shut making it difficult to breathe), difficulty swallowing, and hoarseness. A visit to an otolaryngologist (ENT) can help verify these symptoms with physical exam findings by using in-office flexible laryngoscopy. Anti-reflux diet, lifestyle modifications, and medications can help. Given these symptoms, however, it is not a bad idea to have other conditions ruled out that can be more severe.

It is difficult to say without an exam. Typically the dry winter months can lead to dry mucous membranes in the nose. This can then lead to bleeding. Nasal hydration can help. But an exam by an ENT can pinpoint the problem.

Matthew Vajen

Your pattern of vertigo may represent something other than BPPV. BPPV does not present with hearing loss, ringing, whooshing, or ear fullness. Episodes typically do not last more than a minute or two. You may be experiencing vestibular migraine or Ménière’s disease. A standard workup by an ENT for these symptoms would typically include a hearing and balance test.

Matthew Vajen

There are a host of other viruses that still cause common illness symptoms like these. Typically they take anywhere from 3 weeks to 2 months to totally clear up. Recommended supportive care includes medications like mucinex, as well as nasal saline rinses, decongestants, and anti-inflammatories such as ibuprofen.

Matthew Vajen

Unfortunately, there is no proven treatment for empty nose syndrome. The existing treatments are experimental and only performed by a few surgeons. I could not even tell you where or by whom.

Matthew Vajen