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Dr Puneet Titoria

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Benowa, QLD
Dr Puneet Titoria

Consulting from Benowa. GP referral recommended.

Dr Puneet Titoria is a specialist Ear, Nose and Throat surgeon on the Gold Coast, with a subspecialty focus in rhinology, nasal obstruction, sinus disease, smell loss and nasal airway concerns.

09/09/2026

Perfume. Cold air. Exercise. Why can they make your nose run?

A runny or blocked nose after perfume, cold air, exercise, smoke, alcohol, or a sudden weather change is not automatically an allergy.

Non-allergic rhinitis—or non-allergic rhinopathy—is a pattern in which the nose becomes unusually responsive to non-allergic triggers. Congestion and clear discharge are common, and some people also report post-nasal drip, sneezing, cough, throat clearing, or altered smell.

The distinction is not always obvious. Allergic rhinitis can produce overlapping symptoms, and allergic and non-allergic patterns may coexist. Infection, medication effects, rebound congestion, structural narrowing, and sinus disease may also need consideration depending on the history.

A brief symptom diary can be more useful than trying to remember isolated episodes. Record the trigger, timing, duration, whether one or both sides are affected, and whether itch, sneezing, eye symptoms, blockage, or discharge occur with it.

The purpose is not to diagnose yourself from a trigger. It is to make the pattern clearer so that assessment and treatment can be better targeted.

If symptoms are persistent or disruptive, speak with your GP. Specialist assessment enquiries with Dr Puneet Titoria in Benowa are available using the contact details above.

Sources: International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis 2023; ASCIA, Non-Allergic Rhinitis.

06/09/2026

A blocked nose can be a moving problem

Not every nasal obstruction is a fixed narrowing. In some people, part of the nasal sidewall moves inward during inspiration, reducing the airway at the nasal valve.

This is called dynamic nasal-valve narrowing or collapse. It may be more noticeable during deeper breathing or exercise, when airflow demand increases. Other people have a valve region that is narrow even at rest. Static and dynamic factors can also occur together.

The important point is that nasal breathing depends on more than the septum alone. The nasal lining and turbinates, the septum, and the nasal valve can each contribute—and more than one area may be relevant in the same person.

CT imaging can be useful for selected sinus and anatomical questions, but it does not reproduce the movement of the nasal sidewall during breathing. Nasal-valve assessment is therefore clinical: the history and examination matter, while nasal endoscopy can help identify additional causes of obstruction.

Persistent nasal obstruction should be assessed according to its cause rather than assumed to be “just a deviated septum”. Speak with your GP about whether ENT assessment is appropriate. Specialist assessment enquiries with Dr Puneet Titoria in Benowa are available using the contact details above.

Source: American Academy of Otolaryngology–Head and Neck Surgery, Position Statement: Nasal Valve Repair, revised 2026.

02/09/2026

Post-nasal drip is a symptom, not a diagnosis

“Post-nasal drip” describes a sensation: mucus collecting, moving, or sitting at the back of the nose and throat. It does not, by itself, identify why that sensation is occurring.

Possible contributors include allergic or non-allergic rhinitis, inflammation in the nose or sinuses, a recent infection, environmental irritation, medication effects, or a combination of factors. The sensation can also be more complex than simply producing “too much mucus”.

That is why the surrounding pattern matters. Is there nasal blockage, sneezing or itch? Is the discharge clear or discoloured? Does it vary with meals, exercise, weather, position, or a particular environment? Is there cough, throat clearing, altered smell, or a recurrent versus persistent pattern?

A single symptom rarely selects the correct treatment. For some people, treating nasal inflammation is relevant; for others, a different contributor needs attention. Persistent, one-sided, blood-stained, or otherwise concerning symptoms should be assessed rather than repeatedly self-treated.

If symptoms are persistent or difficult to explain, speak with your GP. Specialist assessment enquiries with Dr Puneet Titoria in Benowa are available using the contact details above.

Sources: International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis 2023; European Position Paper on Rhinosinusitis and Nasal Polyps 2020.

30/08/2026

The spray that opens your nose can also keep it blocked

Topical decongestant sprays can feel remarkably effective: swollen nasal tissue shrinks and airflow improves quickly. The difficulty is that they are intended for short-term relief.

Australian label guidance for common topical decongestants such as oxymetazoline and xylometazoline warns that frequent or prolonged use may cause congestion to recur or worsen. This is often called rebound congestion, or rhinitis medicamentosa. A person may then reach for the spray more often because the nose feels blocked again.

This warning does not apply to every product placed in the nose. Saline sprays and intranasal corticosteroid sprays work differently. It is important to identify the actual product rather than treating all “nasal sprays” as one category.

If a decongestant spray has become necessary for day-to-day breathing, the next step is not simply to keep increasing it—or to stop every nasal treatment indiscriminately. Check the label and discuss the pattern with your GP or pharmacist. Persistent obstruction may also need assessment for underlying inflammation or structural narrowing.

Specialist assessment enquiries with Dr Puneet Titoria in Benowa are available using the contact details above.

Source: Therapeutic Goods Administration, OTC medicine monograph for topical nasal decongestants.

26/08/2026

A blocked nose in a child does not always begin in the same place.

At the front of the nasal airway, swelling of the nasal lining and turbinates can reduce airflow. Allergy, viral illness, irritants, and structural factors may contribute, sometimes in combination.

Further back, the adenoids sit behind the nose. Enlarged or inflamed adenoid tissue can narrow this posterior part of the airway. In some children, tonsils may also contribute to upper-airway narrowing during sleep.

That is why symptoms such as mouth breathing, nasal obstruction, restless sleep, or snoring need context. One symptom alone cannot show where the narrowing is, and snoring by itself does not establish obstructive sleep apnoea or mean that surgery is required.

Assessment considers the duration and pattern of symptoms, nasal and throat findings, sleep concerns, and the child's broader health. Further investigation is used selectively when it would answer a specific question.

If your child has persistent nasal obstruction, habitual snoring, disturbed sleep, or breathing pauses that concern you, speak with your GP for individual advice. For specialist ENT assessment with Dr Puneet Titoria in Benowa, enquiries are available through the practice website.

Sources: Mitchell et al., Clinical Practice Guideline: Tonsillectomy in Children (Update); Cassano et al., Acta Otorhinolaryngologica Italica.

23/08/2026

# Before I discuss sinus surgery, I need more than a scan

A CT scan can show sinus inflammation and anatomy in considerable detail. It cannot, by itself, decide whether sinus surgery is appropriate.

Before surgery is discussed, I need the clinical pieces to fit together: the pattern and duration of symptoms, their effect on daily life, what previous treatment has been tried, what the nasal examination or endoscopy shows, and whether imaging findings are relevant to the symptoms being assessed.

Objective evidence matters, particularly when chronic sinus disease, polyps, or recurrent acute disease is being considered. But an abnormality on a scan does not automatically explain every headache, pressure sensation, or blocked nose. Equally, persistent symptoms do not automatically mean that an operation is the next step.

The discussion may include medical treatment, observation, further investigation, surgery, or a combination over time. The potential benefits, limitations, alternatives, and risks need to be considered in the context of the individual problem and priorities.

The aim is not to find a reason to operate. It is to define the problem clearly enough to decide whether surgery has a reasonable role.

If symptoms are persistent or recurrent, speak with your GP. Specialist assessment enquiries with Dr Puneet Titoria in Benowa are available using the contact details above.

Sources: AAO-HNSF Adult Sinusitis Guideline 2025; AAO-HNS Clinical Indicators for Endoscopic Sinus Surgery.

19/08/2026

When people describe “recurrent sinus infections”, the most useful starting point is often the timeline.

Are there distinct episodes followed by a genuine return to normal? Or do congestion, discharge, reduced smell, or pressure continue between the apparent flares? Did symptoms improve and then worsen again, or did they never really settle?

Those distinctions matter because acute, recurrent, and chronic rhinosinusitis are not the same clinical pattern. They also overlap with other conditions. Rhinitis, migraine or other headache disorders, and dental problems can produce symptoms that are interpreted as “sinus”.

The history therefore comes before the label. Examination may add information, while nasal endoscopy or imaging is considered when it would answer a defined question—not simply because symptoms have happened more than once.

Before an appointment, it can help to note when each episode started, how long it lasted, whether symptoms completely cleared, which symptoms occurred together, and what treatment was tried.

If nasal or sinus symptoms are persistent, severe, or repeatedly returning, speak with your GP. Specialist assessment enquiries with Dr Puneet Titoria in Benowa are available using the contact details above.

Sources: AAO-HNSF Adult Sinusitis Guideline 2025; EPOS 2020; RACGP, Sinusitis.

16/08/2026

# Your turbinates are supposed to swell—but not stay that way

The turbinates are normal structures along the side walls of the nasal airway. Their lining helps warm, humidify, and filter the air we breathe.

They are dynamic rather than fixed. Turbinate tissue naturally becomes fuller and less full as part of the nasal cycle. That normal change is one reason airflow can feel different between the two sides of the nose at different times.

The problem is not that turbinates can swell. It is when swelling becomes persistent, excessive, or repeatedly symptomatic. Allergy, non-allergic rhinitis, irritants, infection, medication effects, and other inflammatory patterns may contribute.

Even then, the turbinates may not be the only factor. Nasal blockage can also involve the septum, nasal valve, polyps, or broader nasal and sinus inflammation. Assessment looks at how these elements fit together and whether the airway changes after decongestion or treatment.

That is why a persistently blocked nose should not automatically be labelled a “septum problem” or a “turbinate problem” from symptoms alone.

If nasal obstruction is persistent or affecting sleep and daily activity, speak with your GP. Specialist assessment enquiries with Dr Puneet Titoria in Benowa are available using the contact details above.

Sources: RACGP, Clinical assessment of nasal obstruction; AAO-HNS, Inferior Turbinate Clinical Indicators.

12/08/2026

As spring approaches, nasal congestion is often labelled either “allergy” or “sinus”—but the two are not interchangeable.

Allergic rhinitis is an immune response in the lining of the nose. It commonly produces combinations of sneezing, itch, clear discharge, congestion, and watery or itchy eyes. Sinusitis involves inflammation within the sinus lining and drainage pathways. Its assessment depends on the full symptom pattern, how long it has been present, and whether it is improving, persisting, or recurring.

There is genuine overlap. Allergic inflammation can contribute to nasal swelling, and allergy and sinus disease can occur together. That is why one feature—such as pressure, mucus colour, or a particular season—does not establish the cause by itself.

The useful question is not simply “allergy or sinus?” It is which pattern best fits, whether more than one factor is present, and what information would change management.

If nose or sinus symptoms are persistent, recurrent, or difficult to distinguish, speak with your GP. Specialist assessment enquiries with Dr Puneet Titoria in Benowa are available using the contact details above.

Sources: ASCIA, Allergic Rhinitis and Sinusitis; AAO-HNSF Adult Sinusitis Guideline 2025.

09/08/2026

A sinus CT can be extremely useful—but only when it is answering the right clinical question.

I do not regard imaging as the automatic first step for every short-lived episode of congestion, discharge, facial pressure, or headache. The starting point is the history: the pattern and duration of symptoms, previous treatment, associated features, and what the nasal examination shows.

CT may add useful information when chronic or recurrent sinus disease is being assessed, when anatomy needs to be clarified, when a complication or alternative diagnosis is suspected, or when treatment planning requires a detailed map of the sinuses.

The scan still has to be interpreted in context. Imaging changes do not automatically explain every symptom, and a scan alone does not decide whether observation, medical treatment, further assessment, or a procedure is appropriate.

The aim is not “more testing”. It is the right test, at the right point, for a defined reason.

If nose or sinus symptoms are persistent or the diagnosis remains unclear, speak with your GP. Contact details for specialist assessment with Dr Puneet Titoria in Benowa are above.

Sources: AAO-HNSF Adult Sinusitis Guideline 2025; EPOS 2020.

Address

Suite 2, Level 1, AHC House, 14 Carrara Street
Benowa, QLD
4217

Opening Hours

Monday	8am - 4:30pm
Tuesday	8am - 4:30pm
Wednesday	8am - 4:30pm
Thursday	8am - 4:30pm
Friday	8am - 12pm

Website

https://www.drtitoria.com/, https://www.noseandsinus.com.au/

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