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Sinus headaches, cracking sensation in nose & between eyes, sore throat. Taken OTC products, zyrtec, sudafed, allegra. No relief.

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In the am my sinuses seem to feel like there cracking and trying to clear I open my mouth and I feel the cracking sensation in my nose and between my eyes. I have constant sinus headaches mainly between my eyes and nasal sometimes causes a sore throat and then moves to my chest. I have tried most OTC products zyrtec, sudafed, allegra, claritin and I use nano ex nothing seems to help. I just feel sick every 4 weeks.

Posted Tue, 22 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 3 hours later

Thanks for the query

You seem to be suffering from a condition of the nose called Allergic rhino-sinusitis.

It is not a mere sinusitis; there is also allergic component in this problem.

The crackling sound you hear is due to opening and closing of the nasal end of the Eustachian tube (the tube connecting nose and the ear). The Eustachian tube is the tube which helps in maintaining the pressure between nose and the middle ear. During nasal congestion the nasal end of the Eustachian tube gets blocked. While yawning, speaking, chewing food and blowing the nose, this tube will open and close giving rise to crackling sound.

Secondly, the constant sinus headache is because of blockage of the sinus openings due to allergy and nasal congestion. And, the sore throat occurs when the secretions from the nose and para-nasal sinuses trickle into the throat causing inflammation of the pharyngeal wall which is perceived as soreness.

Regarding the medicines, you have taken various antihistaminics and decongestants but no mucolytics and saline or steroid nasal sprays. You will require a course of good antibiotics such as combination of amoxycillin and clavulanic acid or second generation cephalosporins (cefuroxime) or newer fluroquinolones (levofloxacin or gemifloxacin), a mucolytic (such as bromhexine or ambroxol), steroid nasal spray, saline nasal spray and an anti-inflammatory medicine (diclofenac or ibuprofen).

Apart from this, you need to do steam inhalation 3-4 times a day, drink plenty of warm water; avoid coffee/chilled beverages/smoking if any.

If the symptoms do not improve with the above medications, please consult an apt ENT specialist. You will require a CT scan of the nose and the para-nasal sinuses to look for any blockage of the sinuses and polyps. The further management will be planned depending upon the findings.

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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