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Experiencing photophobia and cold sensation on forehead. Diagnosed with frontal sinus pressure. Cure?

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I've been periodically experiencing photophobia, 'ice freeze' like sensation on the forehead, general agiation etc. brain fog etc and have come to the conclusion that it's frontal sinus pressure. I've come to this conclusion because recently after a head cold I got the very same symptoms. Would you agree? And how can you drain the frontal sinus?

Posted Thu, 21 Mar 2013 in General Health
 
 
Answered by Dr. Sumit Bhatti 44 minutes later
Hi,

Thank you for your query.

1. A plain CT PNS (Para Nasal Sinuses) is the gold standard investigation. Done on a multi-slice CT Scanner, with 1 mm coronal, axial and sagittal cuts it will settle the issue of frontal sinusitis. The anterior brain will also be covered in this scan.

2. There are some additional symptoms and signs that you may have experienced. Pressure on the inner part of the eyebrow should elicit a pain sensation. Pressure sensation in the forehead on bending forwards, early morning headaches, nasal symptoms may be seen.

3. the initial treatment should always be medical, including anti-allergic, anti-inflammatory, decongestant, mucolytic, nasal steroids, steam inhalation and so on.

4 There are many surgical approaches to drain the frontal sinus. Newer options are Functional Endoscopic Sinus Surgery (FESS) and Balloon Sinuplasty.

5. You should also rule out other conditions (especially if your scan is normal):
a. Eye problems.
b. General health issues such as blood pressure changes, nutritional deficiencies.
c. Benign Intra-cranial Hypertension
d. XXXXXXX Chiari Malformation
e. Atypical Migraine
f. Lyme disease
g. Gastritis, acid reflux and food intolerance

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Experiencing photophobia and cold sensation on forehead. Diagnosed with frontal sinus pressure. Cure? 23 minutes later
I can attest having a nasal discharge at times (clear mucus). Also there can be a more sticky discharge going down the back of my throat also. Lastly there seems to be a cracking in the ears too. I also have to pop my ears quite alot to clear them.

However I don't recalling feeling pain on the inner eyebrow. Leaning forward does induce a pressure but I would put that down to blood rushing to the head.

Would you think that it is most likely frontal sinus pressure inflammation given that I suffer from hayfever (and probably more) and given my throat and nasal discharge and ear issues?
 
 
Answered by Dr. Sumit Bhatti 37 minutes later
Hi,

Thank you for writing back.

Yes, since you have all these symptoms, you should take a two week trial of medical therapy before you consider a CT Scan.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Experiencing photophobia and cold sensation on forehead. Diagnosed with frontal sinus pressure. Cure? 13 minutes later
Hi,

Thank you for your reply.

My last question.

I have tried pseudoephedrine and am currently using flixonase as well. I have also started nasal irrigation. However, I'm concerned about taking too much pseudoephedrine and for the side affects of taking it for too long. Is this dangerous? Can you develop tolerance? Do you have any other suggestions regarding over the counter medications (available in europe).

Thank you.

Best regards,
XXXXXXX
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Hi,

Thank you for writing back.

1. Pseudoephedrine has a good decongestant action, however the rebound congestion and possible side effects such as hypertension, glaucoma and many others have led to a gradual reduction in the dose.

2. Some degree of tolerance does develop and hence long term use should be avoided. Rhinitis Medicamentosa is seen, especially with topical decongestants.

3. You may get generic pseudoephedrine OTC pr get a prescription for Aerinaze (desloratadine 2.5 mg + pseudoephedrine 120 mg) in Europe.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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