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My wife is 30years old and in good health. She

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My wife is 30years old and in good health. She developed a headache 1 month ago that has never gone away. It is on the right side of her head and sometimes feels pressure behind right eye. She has been to her doctor a few times for this and had a CT scan. It showed mucus build up putting pressure on her brain. They gave her a steriod and antibiotic. That helped but soon as after the steriod prescription ran out the headache was back. She takes advil to help with pain but as soon as it wears off it is back. This headache is 24/7. She was referred to an ENT but it will be 2 weeks until she can get in. She has not been congested or any other issues in her nose. She has taken mucinex and claritin but neither helped.
Please let me know what this may be and what may provide relief until the appointment.
Posted Thu, 4 Apr 2013 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 1 hour later

Thanks for the query

According to the description, your wife seems to be suffering from acute sinusitis. Sinuses are the empty cavities in the skull to protect the brain. The acute infection and the inflammation of the sinuses are termed as acute sinusitis. There are few sinuses (ethmoid sinuses) adjacent to the orbit, which exerts pressure on the latter when filled with secretions, thus giving rise to headache.

Usually, following an attack of common cold, there will be nasal congestion, because of which there is blockage of the sinus openings leading to stagnation of the secretions inside the sinuses and increased viscosity of the sinus secretions. Stagnation of these secretions gives rise to headache and nasal infection.

Alternatively, if there is any anatomical block in the nose such as deviated nasal septum or hypertrophied turbinate, negative pressure is created behind the block leading to blockage of the sinus opening thus causing accumulation of the secretions inside the sinus cavities.

As you still waiting to consult an ENT specialist, I would suggest the below measures for the treatment of her sinusitis:

1. Encourage your wife to drink plenty of warm water to keep the nose and sinus mucosa hydrated.
2. Use saline nasal spray followed by steam inhalation 3-4 times a day, which helps in reducing the nasal congestion, opening of the sinus ostia and clearing of the mucus.
3. A course of potent oral antibiotic (such as a combination of amoxycillin and clavulanic acid or cefuroxime).
4. A mucolytic (such as ambroxol or bromhexine) to reduce the viscosity of the mucus and easy clearance of the same from the sinuses.
5. An anti-inflammatory medicine such as ibuprofen or diclofenac for headache.
6. Also, advice her to avoid coffee, chilled beverages, smoking and sleeping under the fan or in front of the air conditioner.

With these measures she should be definitely alright.

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
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