Every day I cough up what looks like a scab with ugly mucous and blood

Hi @needtoknow, I wonder if you still have your problem. I have exactly the same symptoms as you for 2 years now. 2 ENT’s told me it was a staph. Infection, and that nothing could be done. 2 weeka ago i visited a third ENT and after he gave me a CTScan i am up for an MRI next week, for he believes i have a Thornwald cyste ( crust type) The mucus, and every other day a green yellow scab with a red centre.i I developed it after a soar throat. Hope you will reply, for your post is from 2016.

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This is exactly what mine look like as well. This has been going on for at least 3 years. I have searched and searched and searched online for someone experiencing the same problem as me. I’ve gone to the ENT 4 times. I went last week and was prescribed Biaxin because the chunks that I am coughing up are green. So far it has done nothing. I have to get one of those children’s bulb syringes to extract the thick mucus from the back of my throat sometimes. Also, I purchased a dental mirror not too long ago along with a small pen size flashlight. Point the flashlight towards the back of your throat, while holding the dental mirror up at the top of your throat. What I saw was absolutely disgusting. It was like a giant cavity with a lot of green mucus. I even told my ENT this, and never bothered to scope me or look further in to my problem. I’m attaching some pictures of my “scabs” as well.

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I’m so sorry—it looks like you definitely have the same thing I, and likely more than a few folks have on this forum. I completely understand—things have gotten so bad I’m waking in the night choking on this thing. It used to happen every few days, then I had nasal surgery—the airflow improved, which definitely made things worse. Now it’s every day. It’s worse on days I can’t cough it out...because I can feel it there. It’s kind of like how your ears, nose, and throat feel right at the beginning/end of a cold. My humble advice? New ENT, stat! You totally have chronic adenoiditis, and that means low-grade inflammation is happening above your hard palate ALL THE TIME. I had to do a month of antibiotics (did nothing) for insurance purposes, and finally, FINALLY, surgery is scheduled to have the dang things taken out. The last time I was scheduled to have them removed, my insurance changed and I couldn’t afford it. Then this summer, another ENT agreed they needed to come out...but the surgeon decided it wasn’t necessary during my nasal surgery, and DIDN’T DO IT. He was so sure fixing my nose would solve everything...nope. Worse. I went back to him and insisted earlier this month. He tried to blow me off, then the thing that finally seemed to get his attention was when I told him that because of this, my throat hurt every morning, and the base of my ears hurts every night. See that depression in the center of the scab? That’s where your adenoid is, the mucus is dripping back and hardening around it. Sometimes it hardens around the entire thing like in your 2nd picture, and sometimes just the top, like in the 1st and 3rd. Please don’t give up. Doctors work for YOU. It’s my actual job to help them, and all to often the attitude is: “I’m right because, duh, I’m the doctor here.” They aren’t all knowing and all powerful, they make mistakes and overlook things. You deserve to be heard. Good luck. Please keep us updated!

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Has anyone had the cauterization of the area done?

Would love to know if anyone has found any recent success with solving this problem as I have had it for years. Images I have seen look very similar to what I expel daily. Here is where I am at in trying to solve the daily frustration of needing to expel these crusts...

About 3 months ago I went to see 2 ENTS, one being my regular ENT and one being a new one for a second opinion. The new ENT took a look and did make the assumption that I have a Thornwaldt Cyst. 5 days later I had an appoitnment with my regular ENT and I ensured that I did not attempt to clear the daily crust I have to expel as I wanted him to find it with his camera. I explained what the new ENT had said and he went right to the nasopharynx and found the crust. He was amazed at how hard it was to dislodge and once he took it out I felt amazing (as I usually do after I expel it myself but of course takes a lot of work).

At this point I am waiting to get a CT scan done and I discussed with him the idea of electro cauterization as someone posted an article about that procedure. In the meantime here is what he wanted me to do:

- Take 2 x 600mg NAC supplements daily
- Take 2 x Rhinaris oil daily
- Put a small pea size amount of Lanolin into each nostril before bedtime
- Every other day use pulmicort in a nasal syringe, lay on back with head over the edge of the bed and spray half the pulmicort into each nostril - this is mainly to prevent polyps.

The above really has just been a way to help make expelling these crusts easier and does not solve the core issue. At this point Im thinking I will try the Xxylitol rinse method someone mentioned to see how that goes.

Ill update here when I get my CT result and see my ENT again.

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Ps this is one of the links that I found:

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Hi all - made an account just for this thread. Been experiencing exactly these crusts for the past few years, but it’s only recently become more prevalent, like daily sloughing off of the crusts. I read all the same articles mentioned here and was pretty sure I’m dealing with Thornwaldt’s cyst (crust type). Nasal irrigation every night and that gets it for me. First ENT I saw did a endoscopy and found nothing. Sent me home with Flonase. Did not use cause I read that didn’t work for other people. Saw a 2nd ENT and what would he happen to find but the pesky crust just sitting there in the midline of my nasopharynx. He said it’s definitely indicative of Thornwaldt’s. Poked at it and it’s very stubborn. Worth noting he used a rigid scope which I think works better at finding these things cause it goes straight back. It also helped that I had done research and told him where to look, so be your own advocate at these appointments and mention Thornwaldt’s by name. He’s had patients with Thornwaldt’s before so that’s encouraging. CT scheduled for next month to confirm and then we’ll go from there. He mentioned surgery if it’s cystic. If it’s just the crust type, I guess I’ll ask about the electrocauterization. Anyway, hope this gives people a little hope!

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