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Suggest Treatment For Persistent Headache And Facial Pain In An Elderly Person
Question: I am scheduled to have sinus surgery next week. Already had ballon procedure. Was good for about two years. For last 6 to 8 months have had terrible headaches, severe facial pain. Been on antibiotics & steroids more than one could imagine. My family physician ordered a CT. Showed a cyst in in sinus cavity. Located in left lower check area. I go to ENT. First we viewed CT. He showed me cyst. Then told me that My problem area is under my eyes. He first discussed sending me to Allergist. Told him that my quality of life had been terrible for last 6 to 8 months. Then he told me about surgery to put in windows. Said was more invasive. I asked him if cyst could cause trouble for me. Said sometimes not always. Asked him if he planned to remove it. He said if he could reach it. If not would try to decompress or whatever. He didn't seem concerned. Should I be? I really thought I was doing right thing. Now I'm having second thoughts. Please give me dome advice. I'm a 55 year old female.
Brief Answer:
Try more medication before any surgical intervention.
Detailed Answer:
Hi,
Thank you for your query.
1. It would help if you can upload some images of your Sinus CT Scan.
2. An asymptomatic maxillary polyp or cyst less than 50% of the height of the sinus can be left alone.
3. The correlation between headaches, facial pain and sinusitis is barely 4%. Which means that 96% of the time, the cause is not the sinuses. However, in your case, the Balloon Sinuplasty procedure did bring relief for some time, hence the correlation can be considered. Ideally images from any previous scans should be compared.
4. Hypertonic saline nasal washes with budesonide (add 2 budecort respules in 1 liter of saline) will help avoid surgery. These should be used with a non sedating anti-histamine, an anti-leukotriene, a steroid nasal spray and steam inhalation for a few weeks.
5. The allergy is in the delicate lining of the nose, sinuses, throat and lungs. Creating a large window in the sinus may or may not help. A sinus with a large opening is not necessarily a healthy sinus.
5. Allergy tests and attempts at desensitization are also recommended before any surgery.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Try more medication before any surgical intervention.
Detailed Answer:
Hi,
Thank you for your query.
1. It would help if you can upload some images of your Sinus CT Scan.
2. An asymptomatic maxillary polyp or cyst less than 50% of the height of the sinus can be left alone.
3. The correlation between headaches, facial pain and sinusitis is barely 4%. Which means that 96% of the time, the cause is not the sinuses. However, in your case, the Balloon Sinuplasty procedure did bring relief for some time, hence the correlation can be considered. Ideally images from any previous scans should be compared.
4. Hypertonic saline nasal washes with budesonide (add 2 budecort respules in 1 liter of saline) will help avoid surgery. These should be used with a non sedating anti-histamine, an anti-leukotriene, a steroid nasal spray and steam inhalation for a few weeks.
5. The allergy is in the delicate lining of the nose, sinuses, throat and lungs. Creating a large window in the sinus may or may not help. A sinus with a large opening is not necessarily a healthy sinus.
5. Allergy tests and attempts at desensitization are also recommended before any surgery.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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