To Whom This May Apply:
For years, my wife has been periodically impacted by severe sinus headaches apparently caused by changes in the weather. According to earlier appointments w/ the doctor, her sinuses are structurally fine, and therefore surgery is supposedly not the answer. Yet whenever the barometric pressure changes due to a change in the weather, she'll experience great and constant pain with her sinus membranes for a couple of days. And it wipes her out.
Aside from taking 3 or 4 Extra Strength Excedrin, isn't there an appropriate and permanent fix available that would resolve this problem?
Thank you.
Sincerely, A Husband Wanting to Help
Reply: --------------------------
I assume that by "structurally fine" you mean that your wife has had a CT scan of her sinuses and/or nasal endoscopy without any abnormality found. From time to time, otolaryngologists will encounter patients with this type of complaint who have no objective findings of nasal or sinus abnormality. When there is no evidence of significant anatomic abnormality and no evidence of chronic inflammation such as chronic sinusitis, allergy, nasal polyps etc., it may be that such sinus symptoms are caused by inefficient ventilation of the sinuses during periods of sudden dramatic barometric pressure change. Although there may not be an actual anatomic obstruction, this type of problem may be associated with relatively narrow natural drainage channels of the sinuses. Unfortunately, outside of CT scan identification of an actual anatomic abnormality, there is not currently available any objective measure of assessing the possibility that an actual air pressure disturbance might be causing the symptoms you have described. One suggestion would be to try a topical nasal decongestant at the earliest onset of symptoms or, better yet, prior to an anticipated weather front passing through the area if one can trust the weatherperson. Topical nasal decongestants are available over-the-counter and include Afrin or Neo-synephrine. These medications are designed for very short term use and can cause complications and nasal irritation if used regularly for more than 3-5 days. I would suggest trying Afrin twice daily for a day or two immediately before a weather front passing through or at the first onset of the symptoms combined with a non-steroidal inflammatory agent such as Advil, Nuprin, or Alleve (if such medicines are tolerated and not contraindicated).
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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