I'ved had a similar situation as a previous post titled Eustachian Tube Inflamation (dated May 30/96), and here is my situation;
Initially my symptoms seemed to be sinus related, as it still may be as it started with a bad headache for a few days, followed by frontal sinus pressure and in perticular fullness down my ears and nose, down to the top of my mounth, and also in the temple area. This was 3 months ago. (2 weeks following the start of my illness, a death in the family also occured... probably not helping my situation). Now for over a month I'm also getting the dizziness/balance unsteadiness, (although of a minor sensation), definitely NOT spinning or nausea sensation, but frontal sinus pressure, as described above.
Here is the medical attention I'ved seeked chronologically, and still no releif in sight;
My family physician suspects allergies, gives me decongestants until I see an allergist. I also was on antibiotics before going for an X-ray that indicated NO sinus infection. The allergist determined that I had seasonal allergies as I knew when I was a child (taken needles for 5 years), ragweed, dust,pollen, cats/dogs. I was told to take a Nasacort for 2 months, with a decongestant, and also allergy shots for 1 year. (I'm only bothered with allergies in the summer time...)
One week later I saw and ENT, and he tested my hearing and also fills up your ears individually with pressure and graphs the output, and told me that everything was normal. I then asked him if possibly I had viral labyrinthytis, and he responded possibly as this season has been bad, and told me to give it another 6 weeks or so.
It is now going on 3 weeks and some releif in ear fullness, but no releif in frontal sinus pressure accompanied with minor dizziness/balance sensation. I am not taking allergy shots. > > Should one remain on Nasacort for a 2 month period, as I'm not sure if it is really helping, and certainly did not experience releif in the first week as it trials suggests. Should I return on antibiotics as perhaps the sinus X-ray is not known as a reliable source. What can be concluded as my condition, sinuses versus viral. Can stress play a part in this... Can it be neuroligical? What should I expect...
Thanks in advance, much appreciated...
Reply: ----------------------
The symptoms described certainly could be caused by sinus disease. It would appear that your evaluation to this point has been reasonably appropriate. Based upon your description of symptoms and findings it also seems very reasonable for a trial of nasal steroid such as Nasacort. Most nasal steroid sprays are quite safe in recommended dosage even when used daily for long term periods (months - years) since there is little measurable absorption of the topically applied nasal steroids into the blood stream. Nasal steroid sprays in fact are generally designed for sustained long term use and do not usually result in significant improvement of sinus or nasal conditions for the first several days to 1 week of usage. However, if there is no improvement in symptoms whatsoever after 2 months of use, then I would conclude that this approach is ineffective. It might be reasonable to consider a CT scan of the sinuses at this point in an attempt to confirm that your symptoms are indeed related to sinus problems. Standard plain x-rays of the sinuses are much less reliable for diagnosis. A normal CT scan of the sinuses might be cause to consider other possible causes of your symptoms.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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