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Having Sinusitis Since Childhood, Got Jaw Pain, Not Able To Eat. Given Accetofenol And Cetrizine And Efetran. Suggest?

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Posted on Tue, 8 Oct 2013
Question: I am a 26-year old female. I was having sinusitis since my childhood. 9 months ago I got a pain on my left jaw joint. I am not able to chew any hard food or yawn or open my mouth fully. I consulted a general physician first and got Accetofenol and cetrizine tablets. After that I got refered to an ENT specialist. I had efetran, myoril and neksium tablets. Then again in a review I got ossopan and librium tablets and the doctor also asked to cover my ears during journey and have frequent steam. Even after all these treatment, the pain has neither increased or decreased. Can you please tell me the problem and also the treatment for this?
I am working inside an air-conditioned lab. I have a not-so-good sensation in my nose when I inhale the cold air. Is it due to the sinusitis? Is there any precaution or remedy for this? I am currently sitting with my head covered. If I cover my nose, I will feel comfortable. But after sometime, I will feel suffocation due to the covering, which is natural. Can you please suggest a remedy for this?
doctor
Answered by Dr. Sriram Nathan (32 minutes later)
Brief Answer:
Jaw and nose problem

Detailed Answer:
Hello XXXXX and welcome to XXXXXXX

I am Dr Sriram Nathan and I will try to help you with your problems one by one.

Since you have jaw joint pain only on one side it is likely that you may be suffering from a condition called the temporomandibular join arthritis or arthritis of the jaw joint. The treatment in this case is similar to treatment of any other arthritis and the best results are obtained when you give rest to the joint.

-You should completely avoid chewing on the side for a week and then chew only soft foodstuff on the left side after that.
-You should not forcefully try to open the jaw or yawn very vigorously especially on the left side
-Try not to do teeth grinding
-Watch out for any unerupted tooth in the area and get it examined by the dentist
-You may consult an ENT surgeon who may suggests newer treatment like injection of steroid or placenta extract which have shown good results.

Coming to your problem regrading your sensitivity to cold air.
You most probably have allergic rhinitis which is common in the Bangalore climate as it is known as the allergy climate. Initially you may try antihistamines like levocetrizine in consultation with your doctor but the most effective measures are avoidance.
Avoid direct blast of AC or fan, avoid cold water and take steam inhalation.

If nothing works then consult an ENT doctor for the same. If you need any help regarding this you can get back to me.

Hope your doubts have been answered and I will be happy to answer any more you have

regards

Dr Sriram Nathan
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sriram Nathan (1 hour later)
Regarding the jaw problem, I have all my teeth. I had taken rest in the same way you prescribed for over 4 months. But it is not going. I will try consulting an ENT surgeon.

Regarding the sensitivity to cold air. I don't have problem when I am in the open natural climate of Bangalore. I am facing problem when I am sitting in air-conditioned rooms for more than an hour. As my job demands it, I cannot escape from it. Since it is centralized, there is no direct blast of cold air. while traveling and sitting at office, I usually cover my head and ears with a shawl. If I sit without covering, that day itself I will get a headache which goes away if I get a good sleep after steam inhalation. I feel like my nose is getting dried up when inhaling cold air. When I keep a wet towel near my nose and inhale for sometime, the feeling is a bit lessened. Is it an allergy problem? Can you please explain me the difference between sinusitis and allergic rhinitis?
doctor
Answered by Dr. Sriram Nathan (14 minutes later)
Brief Answer:
Sensitivity to cold air

Detailed Answer:
Hello again,

Let me try to explain your doubts in points one by one:

- If you have no problem with the allergic climate of Bangalore then in all probability you are sensitive to the AC environment to which you are exposed all the time. Also most of the times, the AC filters are rarely cleaned which further causes the development of allergy in these closed environment.

- Since it is your work place, there is no escaping this and your only way out is to make sure the AC filters are cleaned regularly and that the difference between the outside and AC temperature is not very extreme (more than 10 degrees). Am sure you can control some aspect of either the blast or the intensity and over time you may get adjusted to the same.

- The headache which you described can either be a sinus headache or a migraine both of which can be triggered by AC blast. Only a proper endoscopic examination along with CT of the nose will give us a clearer picture on this.

- Since you have problems like these and since they become better with steam inhalation, I have a doubt that you may be having a deviated nasal septum along with sinus problem and you need to undergo the above evaluation as soon as possible for the same.

- The alternate drying and humidification of nostrils which you cleverly described seems to be disturbed in your case and thats another reason why I suspect you may have a deviated nasal septum.

- In any case get an Endoscopic examination along with CT of the nose and para-nasal sinuses and get back to me with the reports.

- Finally, Both sinusitis and allergic rhinitis involve the nose and may have overlapping symptoms but they are different entities.

- Sinusitis is an disease or condition in which sinuses (air pockets beside the nose) get inflamed and cause headache and heaviness of head.

-In contrast you can think of allergic rhinitis as the asthma of the nose in which you have sneezing and running nose especially on exposure to dust.

-another condition which I mentioned above is the deviated nasal septum in which you nose central bone is bent and may cause nose block.

Hope your doubts are clear

Regards

Dr Sriram Nathan
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sriram Nathan (15 hours later)
Seeing the description of sinusitis and allergic rhinitis, I think I am having sinusitis. When I am exposed to dust and all I feel some irritation only, no sneezing or running nose. But if I get the headache(even if it is mild), the mucus from my nose will be coming to my mouth as long thick threads and I am not able to force it out from my nose, avoiding it from coming through my mouth. During that time my mouth will have a bitter taste only and I wont get smells also.
If rain pours down on very dry soil, one smell will come which triggers my headache. Since it is now rainy season in Bangalore, this is also causing problems. Are all these symptoms of sinusitis or deviated nasal septum?
And for this condition is there any medication available? Or surgical methods?
I heard the jaw problem and sinusitis have treatment in Ayurveda. Should I try those medications before doing some surgical methods?
doctor
Answered by Dr. Sriram Nathan (30 minutes later)
Brief Answer:
hello again,

Detailed Answer:
Hello again,

By reading into your symptoms I feel that you may have a combination of sinusitis, deviated septum and probably migraine also.

For all these you have treatment in Ayurveda and other methods which include jal XXXXXXX pranayama etc. Also yoga can be tried. But frankly those are not in my realm! I would usually suggest a treatment plan which will include a combination of medication and surgery depending in the CT findings.

You may try the non invasive treatments first and then get back to me for permanent relief.

Meanwhile avoid cold exposure

If you want any details in the surgical or medical treatment you can always contact me

Regards

Dr Sriram Nathan
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. Prasad
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Answered by
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Dr. Sriram Nathan

ENT Specialist

Practicing since :1996

Answered : 1028 Questions

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Having Sinusitis Since Childhood, Got Jaw Pain, Not Able To Eat. Given Accetofenol And Cetrizine And Efetran. Suggest?

Brief Answer:
Jaw and nose problem

Detailed Answer:
Hello XXXXX and welcome to XXXXXXX

I am Dr Sriram Nathan and I will try to help you with your problems one by one.

Since you have jaw joint pain only on one side it is likely that you may be suffering from a condition called the temporomandibular join arthritis or arthritis of the jaw joint. The treatment in this case is similar to treatment of any other arthritis and the best results are obtained when you give rest to the joint.

-You should completely avoid chewing on the side for a week and then chew only soft foodstuff on the left side after that.
-You should not forcefully try to open the jaw or yawn very vigorously especially on the left side
-Try not to do teeth grinding
-Watch out for any unerupted tooth in the area and get it examined by the dentist
-You may consult an ENT surgeon who may suggests newer treatment like injection of steroid or placenta extract which have shown good results.

Coming to your problem regrading your sensitivity to cold air.
You most probably have allergic rhinitis which is common in the Bangalore climate as it is known as the allergy climate. Initially you may try antihistamines like levocetrizine in consultation with your doctor but the most effective measures are avoidance.
Avoid direct blast of AC or fan, avoid cold water and take steam inhalation.

If nothing works then consult an ENT doctor for the same. If you need any help regarding this you can get back to me.

Hope your doubts have been answered and I will be happy to answer any more you have

regards

Dr Sriram Nathan