Sinusitis, Severe Headache, Combiflam. Cure?
Thank you for your query.
1. Get a plain CT Scan PNS (Para Nasal Sinuses) with 1mm coronal, axial and sagittal cuts done on a new multi-slice CT Scan Machine. This is the gold standard investigation for deciding the further course of action.
2. Get a CD of the above scan (also if you have a previous scan/s for comparison), and upload the images onto a free file sharing site such as WWW.WWWW.WW and e-mail a link to YYYY@YYYY with 'Attn: Dr. Sumit Bhatti' as the subject line. You may courier the CD/s at a later stage.
3. There is no substitute for direct history taking and nasal examination. For example, the color of the inner lining of your nose helps identify the cause. Reddish blue or purple signifies acute allergy, Red may signify vasomotor or intrinsic rhinitis. Pale or white nasal mucosa signifies chronic long standing allergy. The location of your headaches can give a clue as to which side and which sinuses are involved. Do you have any other signs and symptoms of sinusitis such as feverishness, post nasal drip? Are your headaches related to the time of the day? Do you have any nasal obstruction, sneezing or nasal discharge?
4. While waiting for the scan results, I always give a trial of 15 days with an anti-histamine and anti-leukotriene, a steroid nasal spray and steam inhalation. Some patients respond well to this regimen. However this should be taken only under the supervision of your local doctor.
5. There are many options available for sinus surgery: FESS (Functional Endoscopic Sinus Surgery, Septoplasty for correcting a DNS (Deviated Nasal Septum), Radio Frequency ablation of Hypertrophied Turbinates. Headaches may also be due to enlarged turbinates causing mucosal contact.
Hope I have answered your query. If you have any follow up queries I will be available to answer them.
Regards.