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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Sinusitis, Liquid Coming Out Of Nose, Allergy, Pressure Behind Eyes While Flying. Causes?

Hi. I m 22 and have been suffering with sinusitis for about 4-5 years now. At this point I have had sinusitis for about 5 months - it gets better-worse-better, but doesn t go away. I have also been diagnosed allergy towards cats, dogs, horses, rabbits, bed bugs, dust and library dust , no allergies towards plants, as far as test have shown. I have recently experienced intense pressure behind my eyes and on my forehead while flying, but flying isn t something uncommon to me - I have done it about 40 times before these incidents. It feels like I get stabbed between my eyebrows and it hurts so badly in my upper sinuses that tears begin running down my face. I have previously taken a CT scan of my nose, but my doctor never reported back on the results, which should mean that nothing bad was found, but I will actually call her on monday to ask her about it. I recently got sick. I can t remember this happening before, but my nose is really runny, but what comes out first doesn t look like mucus at all! There is often clear, sometimes yellow or greenish mucus coming out, which is common for sinusitis, but the main reason for which I have been blowing my nose every 3 to 5 minutes for the last 3 days is that there is a clear liquid that slowly begins to seep out. Is this something normal, or could this be something worse than just a cold? I have read about a possibility for cerebrospinal fluid leaking out... how common is this? Is it important that I go to my current family doctor to get this checked out, or should I wait a little and see if the clear fluid stops dripping out? He usually reacts to my complaints with saying to come back if things get worse... How bad is it that I very suddenly have began getting this very big build up of what seems like pressure when flying? I m gong to have to fly quite a bit the upcoming months and I m worried about the pain I get. UPDATE: yes, the problem was unilateral - the fluid was coming out from only my right nostril. I think I might want to check my nose again...
Mon, 22 Apr 2013
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ENT Specialist 's  Response
Hello

Thanks for writing to H.C.M. for your query.

I have gone through your queryregarding watery discharge from nose, with pressure behind the eyes and throbing pain in fore head between eye brows. It is more marked during flying. The fluid comming out is a matter of worry for you as about it's nature i.e. is it allergic fluid or cerebrospinal fluid.

Here I would like to tell you that allergic fluid and cerebrospinal fluid may be differentiated clinically and by C.T.scan of paranasal sinuses.

Clinically in allergy watery discharge is from both nose (never unilateral), associated with bouts of sneezing. On the other hand in CSF Rhinorrhea discharge is USUALLY UNILATERAL and has comparitively less sneezing.

Finally this condition may be confirmed by C.T.scan of paranasal sinuses and by BIOCHEMICAL & CYTOLOGICAL examination of fluid.

So a thorough ENT examination and relevent investigations as discussed above will help in making correct diagnosis that may be accordingly manage.

Regards.
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

     CSF leakage is an ominous occurrence and is not common / Disruption of the base of the skull due to fracture from trauma or erosion from tumour is responsible / it can easily be diagnosed by chemical analysis of the fluid and by CT scan / You should see a Neurosurgeon

     Green or yellow discharge means infection / you will need antibiotic – generally a broad spectrum covering anaerobes...
If there are several known allergies and the duration so long, you may benefit from de-sensitisation...
     Anti-histamine, Leukotriene inhibitors, decongestant help / Steroids may be needed...
     You should continue to follow up with ENT specialist
     A second opinion may also be useful

Take care
Wishing speedy recovery
God bless
Good luck
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Sinusitis, Liquid Coming Out Of Nose, Allergy, Pressure Behind Eyes While Flying. Causes?

Hello Thanks for writing to H.C.M. for your query. I have gone through your queryregarding watery discharge from nose, with pressure behind the eyes and throbing pain in fore head between eye brows. It is more marked during flying. The fluid comming out is a matter of worry for you as about it s nature i.e. is it allergic fluid or cerebrospinal fluid. Here I would like to tell you that allergic fluid and cerebrospinal fluid may be differentiated clinically and by C.T.scan of paranasal sinuses. Clinically in allergy watery discharge is from both nose (never unilateral), associated with bouts of sneezing. On the other hand in CSF Rhinorrhea discharge is USUALLY UNILATERAL and has comparitively less sneezing. Finally this condition may be confirmed by C.T.scan of paranasal sinuses and by BIOCHEMICAL & CYTOLOGICAL examination of fluid. So a thorough ENT examination and relevent investigations as discussed above will help in making correct diagnosis that may be accordingly manage. Regards.