Persisting Facial Pain and Pressure
Facial pain is a form of headache that is common and often recognized by patients as a “sinus problem”. Pain in the forehead, in the cheek area and around the eyes can have a number of causes. Facial discomfort can vary in severity from constant pressure to severe aching with referral of symptoms to the teeth and ears. Acute sinus infections are associated with discolored nasal discharge, throat irritation, and even fever.
Managing facial pain with medication is possible. Antihistamines work best for itching and sneezing symptoms and can make the nose and throat feel more comfortable, but may not improve facial pain complaints. Nasal steroid sprays should improve congestion since they are topical anti-inflammatory medications. However they do not work immediately and their effectiveness cannot be assessed prior to two weeks of regular use. The antileukotriene medications block the effects of chemicals that are produced late in allergic and other inflammatory reactions and can be helpful as well. Patients often use decongestant medications to relieve facial pressure above, below and around the eyes, but pseudoephedrine containing over-the-counter medications and topical decongestant sprays such as oxymetazoline can have significant side effects in the nose and the cardiovascular system limiting their usefulness, particularly in older patients. Environmental controls based on allergy test results can help your medication choices work better for you.
Patients with persisting facial discomfort who are already being treated for their allergies may be candidates for procedures that dilate sinus openings, improve ventilation and therefore reduce or eliminate facial pain and pressure. These may include turbinoplasty, septoplasty, traditional endoscopic sinus procedures (FESS), or office balloon sinuplasty (OBSP). The appropriate treatment can be chosen based on the findings of a complete history and physical exam, endoscopic evaluation of the nose, CAT scan results, allergy testing, and in some cases an immune evaluation.
In summary, sinusitis and allergy symptoms often overlap and an evaluation should be sought for persistent facial pain complaints and recurrent sinus infections to determine what treatments are right for you. Dr. Brandeisky is board certified in general ENT with a a certificate of added qualifications in otolaryngic allergic allergy. He has 23 years of experience within the specialties, and applies strict medical principles to the evaluation of patients and the selection of appropriate therapies as they apply to and are accepted by patients as individuals. If you feel you have persisting and chronic nasal and sinus complaints, have experienced unsatisfactory surgical results, or believe you suffer with allergy rhinosinusitis consider contacting Dr. Brandeisky’s office today or book a convenient appointment through ZocDoc.com.