Question about paranasal sinuses - #14780

Hello Riza By going through your history and evaluation of your health status I must say that your CT shows chronic maxillary and sphenoidal sinusitis, especially on the right side. Sinusitis means the lining of your sinuses is inflamed and swollen, often due to infection or allergies. When you catch a cold, the inflammation gets worse, and the sinuses can get blocked. This leads to pressure build-up, which causes headaches that can last for weeks—even after the cold is gone.

About your migraine concern I must say that It’s possible, but less likely if your headaches always follow a cold and you have chronic sinus issues. Migraines usually have other symptoms like nausea, sensitivity to light/sound, and may not be linked to colds.

For better evaluation see an ENT specialist for a review, especially since FESS didn’t fully help. - Sometimes, chronic sinusitis needs ongoing management (nasal sprays, allergy control, saline rinses). - If headaches change in character, become severe, or you get other symptoms (vision changes, weakness, confusion), see a neurologist to rule out other causes.

Thank you

Headaches for many years No facial pain Constant pressure or throbbing Symptoms like:

Noise/light sensitivity

Nausea during headaches

Headache worsening with stress or menstrual cycle

These suggest migraine or neuralgia instead of pure sinus disease.

A neurologist may prescribe:

Preventive meds: Topiramate, Propranolol, Amitriptyline

Acute migraine meds: Triptans

These can improve headaches dramatically.

Hello dear See as per clinical history sinusitis is a mazor factor for consistent headache Since you are already undergone fess treatment, I suggest you to please continue consultation with your ent surgeon for follow up and recovery. In addition, You can take opinion of neurosurgeon to rule out any cerebral or brain related a nn anomaly In the mean time you could be given Nasal congestant like epiderine or salmetrol Anti-inflammatory medication like paracetamol or voveron xr Tramadol on prescription by neurologist only I suggest you to please have review of both the above-mentioned specialities for clear review Regards

Hi Riza, I completely understand how frustrating it must be. Here is my advise.

1. Why headache - In your situation the headache might be due to allergies, incomplete sinus clearance, polyps, infection, etc, also migraine and tension headache should be kept in mind too.

2. Recommended Next Steps: -ENT re-evaluation with nasal endoscopy – to check if sinuses are open and clear. -Sinus culture/swab – to rule out resistant bacteria or fungus. -Allergy testing – because allergic inflammation often maintains sinusitis. -If ENT clears sinus cause, consult a Neurologist to rule out migraine variants (sinus and migraine often overlap).

3. Management Tips- Use saline nasal rinse twice daily. Steam inhalation regularly. Avoid dust, perfume, cigarette smoke, and cold drinks. If headache persists beyond sinus healing → discuss migraine prophylaxis with a neurologist.

Feel free to reach out again.

Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Med

Chronic sinusitis can indeed lead to persistent headaches, particularly if the inflammation or infection doesn’t resolve effectively. Even after Functional Endoscopic Sinus Surgery (FESS), it’s possible for sinus issues to recur or persist, especially if any underlying factors remain unaddressed. The maxillary and sphenoidal sinuses are closely linked to nerves in the head, which could explain your headache symptoms, especially upon exposure to cold, which can aggravate sinus congestion and inflammation. Since your CT report indicates chronic sinusitis with exacerbations, it suggests that there might still be ongoing inflammation or blockages affecting these sinuses. Persistent headache could be due to lingering or recurrent inflammation, secretions buildup, or pressure differences in the sinus cavities. You mentioned that the headache persists for about a month after cold exposure, which is relatively long and might indicate complex interactions perhaps other conditions like migraines could be considered. Migraines often have distinct characteristics, such as throbbing pain, sensitivity to light, or nausea, which might help differentiate them from sinus-related headaches. It’s crucial to follow up with a healthcare provider to examine other possible causes if your headaches don’t respond to usual sinus treatments. Exploring further testing or getting a neurology referral may help rule out or confirm any neurological conditions if symptoms persist. In the meantime, managing sinus inflammation with saline rinses, decongestants, or corticosteroids may provide some relief, but always do so under a physician’s guidance.