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This may be an initial presentation of a spontaneous CSF leak or appear after treatment such as an epidural patch, and likely indicates a slow spinal CSF leak. [30] While high CSF pressure can make lying down unbearable, low CSF pressure due to a leak can be relieved by lying flat on the back. [31]
In addition, patulous Eustachian tube generally feels dry with no clogged feeling or sinus pressure. Patients hear their own voice or its echo from inside. [3] [4] They describe it as being amplified and unpleasant. Lying head down may help since it increases venous blood pressure and congestion of the mucosa.
[5] [8] There are three main treatment approaches: weight loss, different medications and surgical interventions. Remission is seen for most patients that achieve a weight loss of around 6–10%. Bariatric surgery can be an option for those patients that don't achieve weight loss with lifestyle changes and diet. [22]
The major symptoms of ENS include a sensation of suffocation, nasal dryness, nasal burning, nasal crusting, and an impaired sense of airflow through the nose in patients who have had surgery or injury to nasal turbinates. [13] ENS can greatly reduce a patient's quality of life and many patients struggle to complete activities of daily living.
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He further observed and documented that the turbinates in the dependent nasal fossa fill when the patient is lying down. The nasal cycle is an alternation in both time and between left and right sides, with the total resistance in the nose remaining constant. The asymmetric airflow may have some benefit to overall olfactory sensitivity. [6]
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