Examined first, then treated. Nose and sinus care in Dubai

Inside the nose there is a dividing wall, the septum, and on each side a set of swelling structures called the turbinates. They take turns narrowing and opening through the day. That rhythm is normal, and most people never notice it.

What is less usual is one side that never opens properly. A septum sitting off centre, a turbinate that stays enlarged, or the two together can hold that side closed. A spray can shrink swollen tissue for a while, but it cannot move a wall.

This is why the examination comes before any recommendation. Once the shape of the airway is visible on screen, the reason for the blockage is usually clear to both of us.

The sinuses are air spaces around the nose that drain through narrow openings. When the lining swells, those openings close, and pressure, congestion and thick discharge follow. An infection that clears and returns every few weeks is behaving differently from a single cold.

Recurrent and chronic sinusitis usually has something behind it: a narrow drainage pathway, an untreated allergy, or nasal polyps, which are soft swellings of the lining. Polyps are one of the more common reasons smell fades and does not come back on its own.

Reduced or absent smell is worth mentioning at the consultation even when it feels like a small thing. It tells us where in the nose the problem is likely to sit, and it changes what we examine.

Indoor life here is air-conditioned for most of the year. Cooled air is dry air, and a dry nasal lining has to work harder to filter and humidify every breath.

Add fine desert dust, construction dust, house dust mites indoors, and the moulds that can gather in filters and ducts. For some people this shows up as a nose that blocks at night and runs in the morning. For others it turns a mild septal deviation, one that caused no trouble in another climate, into a daily problem.

Symptoms that appear in the first months after arriving are worth testing rather than guessing at. Consultations at Quttainah Specialized Hospital on Al Wasl Road, Umm Suqeim 3, are held in German, English, Spanish or Farsi.

Decongestant sprays open the nose quickly. Used for longer than a few days, the lining can begin to rely on them, and the congestion returns sooner each time. The pattern has a name: rhinitis medicamentosa, or rebound congestion.

The spray was never the treatment. It was covering something else, most often a deviated septum, an allergy, enlarged turbinates or sinus inflammation. Each of those is managed in a different way.

Coming off a spray you have used for years is done gradually and with support, alongside treatment for whatever was blocking the nose in the first place.