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Treatment for persistent FRONTAL, MAXILLARY SINUS pain.

Resolved Question:

How can I cure my persistent sinus pain (frontal & maxillary sinus and temple)?

I have had a dull pain in my left maxillary sinus for over a month now and slight throbbing in my left frontal sinus. I also have pressure behind my left eye and right temple which is causing mild pain.

I can get some relief from the pain by placing the palm of my hand on top of the maxillary sinus and over my eye and gently pressing on it. I also have to press my left temple to get relief. I am also feeling very lethargic and irritable.

These symptoms were brought on from a mild cold over a month ago. My doctor checked my nose and noticed mild swelling in the left maxillary sinus. He prescribed 7 days antibiotics and prednisolone 5mg (3 tabs 2 times per day). He also recommended I take a decongestant and use a saline wash 3 times per day. My condition did not improve over this period.

Last year around this time I had frontal sinus endoscopy surgery after MRI/CT scan showed I had a blockage which was causing an infection (see images attached). My symptoms are similar this year but not so severe.

I also have a mild tightness in the chest (no wheezing) which I believe is linked to the allergy/sinus symptoms. I had asthma as a child and the tightness feels similar to when I had dust/pollen allergy.

Is it possible I still have an infection or could these symptoms be linked to an allergy.

Thank you for your help.


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 posting your query at DoctorSpring.com

I can understand your problem.
You are suffering from left hemi facial pain for a month time, you are treated with a course of
antibiotic and steroid for a week for sinusitis, still you have same symptoms.Your symptoms are not classical of sinusitis as pain is improving on gentle pressure over sinus area but usually in sinusitis
we have tenderness on pressure over sinus area. same time you do not have persistent nasal obstruction,
purulent nasal discharge and post nasal drip. Even in your last mri picture you have mild frontal sinustis on left side.
anyway first to get correct diagnosis we need to do imaging again so you can do either CT PNS or MRI
brain. CT will give adequate information but there will be radiation exposure.
MRI there will not be any radiation exposure and in MRI Brain we can rule out any pathology related to
brain and we can see all sinuses in different cuts.
Once we know correct diagnosis it will be very easy to treat it.
Hope this helps,

Best Regards


Patient replied :

Dear Dr Sunil Jalan,
Thank you for your reply. I visited the hospital and the doctor who operated on me last year recommended a CT scan so he could see the boney structure. This scan showed mild thickening in the maxillary sinus, everything else looked ok.
I also had a blood test and everything looked fine.
He checked my nose and discovered a little puss in the maxillary sinus and small polyps.
He has given me a different type of antibiotic to take (7 days) and pulmicort recapsules to add to my sinus wash.
Two days later I still have the same symptoms. I guess I need to give it time to work.
One more point; I have a mild pain in my lower left gum right at the back. Could this be aggravating the symptoms or are these nerves linked to the sinus? I guess I need to get a dentist to check this.
Thanks


Expert:  Dr. Sunil Jalan replied 3 Days.

Hello,

Mild mucosal thickening will not cause symptoms as you have. So a dental opinion will be helpful at least to rule out any dental pathology.

For mild sinusitis you can start nasal spray including Mometasone nasal spray one spray two times daily for 6 weeks. Steam inhalation may be useful.

Hope this helps,


Best regards


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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