My husband has been addicted to nose spray for about 20 years. He tried to stop about 14 years ago, but he did not stick with it. He can't stand not being able to breathe through his nose. What procedures or treatments would you recommend?

G.D.

The medical term for this condition is "rhinitis medicamentous," which translates as nasal inflammation (rhinitis) due to medication (medicamentosa). It is almost exclusively due to abuse of over-the-counter decongestant sprays.
These sprays are potentially very harmful and are intended for short-term use only. Your husband needs to have his blood pressure checked regularly, as the medicine can cause or worsen high blood pressure. He also needs to realize that his nasal obstruction is a rebound effect from overuse of the spray. He is "treating" nothing. He is only perpetuating his addiction.

This is a very difficult problem to correct. As with any addiction, the patient must want to quit. If the patient is properly motivated, he or she can be weaned from the spray gradually or quickly, using nasal steroid sprays and decongestant pills to offset the horrible congestion that will result from withdrawal. An ear, nose and throat specialist (ENT) would be the best-trained individual to supervise this transition.

If your husband's nasal obstruction is partly due to bad anatomy (a deviated septum, for example), surgery could help improve his airway. A thorough examination of his nose (often requiring the use of a fiber-optic viewing device called an endoscope) is necessary to determine what operation, if any, may be appropriate. Once again, an ENT would be the most appropriate doctor to perform such an examination.