How long a pt can continue montelukast levo or fezofenadine and levo?

Pt complaint of nose blocked every now and then and frontal pain sneezing very frequently during cold winter season or xposed to dust and pollens Since ten yrs. He was adv by one ENT to get surgery due to DNS but pt refused .hes under metaspray and montelukast and levoceterizine sometimes he shift to fezofenadine ,levoceterizine since then . He got relief by taking those meds but how long he can continue? Thank u

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Most likely diagnosis would be that of a deviated nasal septum(DNS) with allergic rhinitis(AR). The sneezing can be cintilled with the medication, but the blocked nose would requires septal correction. The blockage of the frontal outflow tract causing frontal headache, could be because of the DNS with AR. A diagnostic nasal endoscopy would reveal any obstruction. It would be ideal to get a CT PNS done if the patient agrees for surgery. Other medical management includes specific allergy testing and immunotherapy.

Thank you doctor
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Symptoms suggest obstructive nasal septum deviation and hence chr frontal sinositis. Constant use of metaspray will lead to nasal mucosal atrophy or metaplesia hence pt should be motivated to under go nasal septoplasty Yes pranayam jal nedhi grit or sutra nedhi will help but under supervision of trained yogi So far duration of antihistamines+monteleukast is concerned it is to be used intermittently

Thanx dr Dinesh Gupta
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Xray of sinuses , if displayed, will be useful. CT sinuses can give added information. Serum IgG levels, Absolute Eosinophil counts , stool examination for infestations will be informative. Avoidance of dust, wearing face masks or nasal dust filters can help. Pranayamam done properly can have a significant benefit. Monteleukast, Duonace nasal spray can be continued.

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Fexofenadine with montelukast combination is safest and effective in this case , patient should start this before the allergic season and must take throughout the season

Thank you doctor
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DEPENDS UPON.. ..THE. EFFECT. OF. THE. MEDICATIONS AND SIGNS. AND. SYMPTOMS. .. WHETHER TO. CONTINUE OR. WITHDRAW...

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I agree with Dr krishnan pichumani sir

Thank you ,Dr Dutta
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It's seems like a case of DNS with Allergic rhinitis leading to frontal sinusitis.if the nasal block is predominantly on one side and if the frontal headache on same side then a septal correction required. If the block is alternating use of short course of oral steroids followed by use of topical steroids like fluticasone for atleast 3 months may relieve symptoms.

Thank you doctor
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