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Dr. Andrew Rynne

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Took all the possible treatment for sinus. Should i go for sinus surgery?

Answered by
Dr. Naveen Kumar

ENT Specialist

Practicing since :2001

Answered : 2387 Questions

Posted on Mon, 7 Jan 2013 in Ear, Nose and Throat Problems
Question: I have sinus problem which i have noticed 5 years back. I had started taking medicine after that, first english medicine for 1.5 years then homeopathy for 2 years, after that i have moved on Ayurvedic medicine. But problem continues. I need your advice whether i should go for sinus surgery. FYI, i have high cholesterol as well - 240.
Answered by Dr. Naveen Kumar 35 minutes later

Thanks for the query

The symptoms you have described are the features of Seasonal Allergic Rhinosinusitis.

Allergic rhinitis is a common condition characterized by an immunoglobulin E (IgE)-mediated inflammation of the nasal mucosa following exposure to allergens.

During allergic rhinitis there is inflammation of the nasal mucosa causing blockage of the sinus openings leading to accumulation of the nasal secretions in the sinus. Also, there is trickling of the nasal secretions behind the throat causing throat discomfort and cough.

The pollen, dust, fumes, coils smoke, etc. are the common triggers of allergy. The bitter truth is, “there is no cure for allergy, and only the preventive measures when followed can get rid of allergy”.

Preventive measures such as avoiding the triggering allergens such as dust, smoke, strong perfumes and changing the pillow cover every night before going to bed can reduce the further attacks. Also, avoid sleeping directly under the fan or in front of the air conditioner.

If the sinuses are blocked, you will definitely require surgical intervention in order to clear the block. But, after surgery you will have to switch on to the preventive measures and use steroid spray for at least six months.

Before getting operated you need to get a CT scan of the paranasal sinuses done to assess the amount of block and study the anatomy of the nose and paranasal sinuses.

High cholesterol is not a contraindication for surgery.

For the time being you can try the following:
1. To use steroid (such as Momentasone/ Fluticasone) nasal spray once a day, this reduces nasal allergy and itching in the eyes.
2. To use saline nasal spray followed by steam inhalation 3-4 times a day, this will help in opening of the sinuses and easy clearance of the sinus secretions.
3. Use a mucolytic such as Bromhexine and Ambroxol, this helps in thinning of the tenacious secretions.
4. An antihistaminic such as fexofenadine /cetrizine/loratidine taken will reduce the allergic problems.
5. Drink plenty of warm water and to avoid chilled food or beverages and coffee.
6. Avoid smoking/coffee if any
7. Cover your nose and mouth with a clean cloth (or wear a mask) when exposure to dust or smoke is imminent.
8. Consult a good ENT specialist for a thorough examination and further management.

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

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Naveen Kumar 38 minutes later
Thanks for your advice. I think i should mention my problem in detail here. I usually feel headache, pain on my face, i feel some relief if i press on my jaw (if there is pain on face or headache). Pain includes pain in eye, eye brow, and all area of the face. some time pain in ear as well. I feel itching in the ear also. there was some whistle sound also coming earlier, but i have not noticed that recently. throat is chocked with cough very frequently. body pain, feel low energy. and the pain starts anytime it is not dependent on any specific thing like if i donot eat for long, it starts, i go out for walk / travel, it starts. if i go the place with winter weather, it starts. if it is hot, it starts. and sometime i feel like vomiting when there is pain. so, i am confused and clue less that what should i do. Thats why i was thinking if operation can help in this OR better to avoid operation and it can be handled by some other way. Kindly suggest.
Answered by Dr. Naveen Kumar 28 minutes later

Welcome back and thanks for a detailed explanation.

All your symptoms are suggestive of Seasonal Allergic Rhinosinusitis. The relief in pain following pressure over the jaw is due to suppression of the trigeminal nerve supplying the face.

First of all consult a good ENT specialist at your place, ask for a CT scan of the nose and paranasal sinuses. After seeing the report plan for further management. Meanwhile follow the measures mentioned in my previous response. Once you get a CT scan, mail the images to me, I will guide you accordingly.

I wish you good health.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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