Management of aspiration of Nasya medicine into Eustachian tube as a complication of Shodhana swarasa nasya

Panchakarma (~five internal bio-cleansing therapies) is practiced in the Ayurvedic system of medicine . Nasya karma (~medication through nasal route/errhine therapy) is one among them and is considered the best therapy for Urdhwajatrugata rogas (~diseases of part of body above the clavicle). Apart from its local action in diseases such as Pinasa (~chronic rhinitis), Nasya is mentioned as a prime treatment modality in many systemic disorders such as Kushtha (~integumentary disorders), Apasmara (~Epilepsy), Unmada (~Insanity), etc. Thus, it provides a scope for both local and systemic drug effect. Like other therapeutic interventions, it is not entirely free from risk as complications or Adverse Drug Reactions may arise from improper administration, inaccurate drug selection, patient negligence, or various environmental factors such as smoke, dust or cold wind. Here, a case report of a patient with complaint of earache due to aspiration of medicines of Swarasa nasya (~juice of medicinal herbs given through nasal route) into the Eustachian tube and its management through Ayurveda is being presented. Thus, a retrospective analysis of the medical records of the patient highlights the occurrence of such complications and their successful management through Ayurvedic interventions. This case emphasizes the importance of accurate medicine selection, proper administration, following behavioral and dietetic restrictions, proper assessments and awareness of possible complications, thereby underscoring the need for vigilance while practicing Nasya therapy.