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Chronic Sinusitis.

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Have had a long standing sinus issue (probably sinusitis) in which I have been given two rounds of antibiotics and a sinus exam which didn't reveal any problems. Now, 8 weeks later there is still fluid in the left side of my face and head which includes the left ear. My head feels like it is floating with fluid and when I swallow I feel the left ear and there is slight impairment with blurry vision at times. There isn't a lot of pain (as in pressure) only this odd sensation of fluid around the left side of my head, ear, and/or, skull. Have been taking herbal remedies at present as the condition hasn't been getting any better. Could there be something else wrong, or, are there any other treatment options?


Category: ENT Specialist

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Category: ENT Specialist
Dr. Sunil Jalan is online now

Expert:  Dr. Sunil Jalan replied 4 Days.

Hello,

Thank you for using Ask a Doctor Service from Doctor Spring.

You are suffering from pressure sensation of fluid in left side of head, ear and skull. You are treated with antibiotic for sinusitis but still no relief.

To decide about your treatment we should get the correct diagnosis.
To get the correct diagnosis I need some more information and it may require investigations.

Do you have nasal symptoms including –
• Nasal obstruction – if yes right or left
• Nasal discharge – watery/ thick/ yellowish/ crusts
• Excessive sneezing or not
• Any loss of smell

Do you have headache, if yes duration, frequency, If is episodic, then duration of episodes on average.

Do you have any other eye symptom?

So you have hearing loss or blocking sensation in ear, all the time or intermittent?

Do you have any facial pain?

Do you have fever/nausea/vomiting?

In your present description it doesn't looks like sinusitis.
To see the status of sinuses, we can do CT scan of paranasal sinuses.

You do not have any alarming sign or symptoms, so no need to worry. But to get correct treatment send me following details. You can get opinion from local ENT specialist who will able to do complete examination also.
Hope this helps. Please get back with answers to the above and feel free to ask if you have any further queries.

Thank you.
Regards
Dr. Sunil Jalan


Patient replied :

Have already been to a doctor:

I have already seen an ENT specialist (ear/nose/throat doctor) and he told me everything was okay from what he saw in the sinus examination and this includes a CT scan which came back clear - meaning nothing unusual appeared in the scan. So, I still have symptoms - so what are they missing or not seeing??

The only nasal discharge is mostly from a runny nose and the doctor gave me Ipratropium nasal spray and the mucous has always been clear with no coloration.

There is hardly any sneezing and no loss of smell and no fever, nausea, or, vomiting. There is very little sinus pain only some fluid pressure around the left eye and left ear and left side of the head like in the skull. Sorry, it is difficult to give a proper description of these symptoms!

The point is I have have this **** for 3 to 4 weeks now (after the two rounds of antibiotics) and all the doctor does is tell me that I had a "virus" and my sinuses are okay and gives me the one spray (Ipratropium) for the runny nose. I am now treating myself with several natural and herbal remedies which are helping only somewhat - need to see a resolution to the problem.

The larger issue is what is causing this residual fluid build up (mostly around the left ear) and why is it not going away?

Perhaps there are allergy-related symptoms, or, is this only fluid in the ear that will take several more months to heal?

All I can do is to take the natural/herbal remedies and hope for a gradual healing process.


Expert:  Dr. Sunil Jalan replied 3 Days.

Hello,
So your main symptoms are heaviness or pressure symptom on left side of face and left ear block.
You are correct sir, most likely your symptoms are due to allergy. But you don’t have sinusitis, because in CT we can clearly see all sinuses and can see if minimal sinuses is involved or not.
Ear block without pain usually occur following cold or allergy with may cause block in eustachean tube (tube connecting nose and ear).
We can start following medication:
• Mometasone (metaspray ) - Nasal spray twice daily

• Antihistamine medication for same including Tab.Levocetrizine 5 mg once daily for 15 days.


Hope this helps. Feel free to ask if you have any further queries.


Thank you.


Dr. Sunil Jalan
Category: ENT Specialist
Experience: 
DAA (Diploma in asthma and allergy) : Christian Medical College, Vellore, 2012
D.N.B (ENT), 2011
Residency - M.S. (Master post graduate degree in otorhinolaryngology),  Christian Medical College, Vellore, 2009
D.L.O. (Diploma in otorhinolaryngology) - Christian Medical College, Vellore, 2007
Medical School - M.B.B.S, S.P. Medical college, Bikaner, 2004
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