NASAL DROPS
       Nasal Drops are associated with lot of controversies. ENT Surgeons can't live without it, paediatricians hate it and others have mixed feelings.
       The importance of the Eustachian tube (ET) function can't be underrated. The moment the ET is blocked by a URTI the middle ear cleft is in jeopardy.
This can happen in one of the following conditions mentioned below:
  1. In children an adenoid hypertrophy and sepsis can cause an inflammation to ET orifice.
  2. In adults recurrent nasal allergy with septal deflection nasal polyposis can cause ET block.
  3. Allergy and inflammation can cause overall inflammation of nasal cavity and sinus stasis which subsequently results in septic Post Nasal Drip (PND) which can cause ET inflammation.

Judicious use of nasal drops can prevent all these causes.

       In the treatment of upper respiratory catarrh the nasal drops is the first and emergency measure preceeding antibiotics, anti allergy and nasal decongestant medications.

        We see a number of cases of intractable CSOM improved and cured with use of Nasal Drops along with systemic medications.
The most effective way of using the Nasal Drops are
  1. Apply it in time and in necessary frequency.
  2. Apply it in proper position (see figure)
  3. Apply it in proper concentration. (E.g. Saline Nasal Drops are useful only in newborn and infants).
  4. Do not sniff violently or squeeze the nose after applying nasal drops. Allow it to drip slowly and try to retain it in the nasal cavity as long as possible for better absorption.
Note :
  1. If someone has to survive only on nasal drops he or she will require more investigates to probe for a surgical cure. (E.g. Septal deflection or Polyposis)
  2. Rhinitis medicamatosa is a theoretical condition seldom seen in practice.
  3. The possibility of blocked nose causing increase in BP in hypertensive is more probable than a nasal drops causing it.
  4. Patients should be instructed to throw away the metal cap of the Nasal Drop bottle and use the filler-cover of the bottle to close the bottle to avoid contamination.
    
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