Brief Answer:
Chronic Sinusitis most likely

Detailed Answer:

Hello,

The upper nasal pressure, the sensation of sunken eyes and fatigue are all descriptive of chronic sinusitis. Sinusitis is basically bacteria entering the air cavities in the facial bones, causing irritation and inflammation which manifests with stuffiness (felt as pressure), as well as allergies and chemicals entering these cavities.

An effective way to diagnose sinusitis is through rhinoscopy, which is the insertion of a thin tube through your nose and into the sinuses in order to directly see the insides of the sinuses. However, a CT scan or MRI of the paranasal sinuses is the best method to diagnose.

In the meantime, using nasal saline irrigation with sprays or solutions is an effective way to rinse away irritants and allergens causing the inflammation, which should relieve the feeling of pressure, improve breathing and decrease the fatigue. If this does not bring the desired relief, I'd recommend the use of prescription-based corticosteroid nasal sprays such as Flonase, Veramyst, or Rhinocort.

If these fail to bring you any relief, I recommend you see an ENT specialist for an in-person examination and further evaluation.

I hope this helps.

Take care.

Regards,
Dr. Ornela Ademovi, General & Family Physician

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