Are facial and ear pain related to my seasonal sinus allergy?

Hi,

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I can understand your concern. The most common reason for your symptoms is severe allergic rhinitis with associated sinusitis. I have tried to explain the cascade of events in a simple manner below: Exposure to dust or any irritative substance will initiate reflexes such as sneezing to remove the offending agent. If this fails, mucosal cells in your nose start to hyperfunction producing loads of mucus to trap dust (owing to its sticky nature). This mucus will be blown out of the nose or pushed into the throat due to mucociliary activity. The throat initially reacts by activating cough impulses to push out the mucus. Still, if that fails, local inflammation around the throat starts, leading to symptoms such as the feeling of a lump in the throat and clearing the throat often. A long-standing inflammation around the nose leads to the involvement of the eustachian tube (a small canal that connects the middle ear and throat), which ventilate air and equalize pressure between the nose and the ear. Inflammed tubes do not function well, which leads to a resultant negative pressure in the ear, causing ringing sensations, muffled noise, and sometimes decreased hearing. Long-standing inflammation in the nose also blocks the sinuses' outflow tract, leading to collected secretions that get infected and cause a pressure headache around your eyes, forehead, and cheeks. Your glands also get swollen for the same reason. I know the problem has been there for a long time, but I am not sure if you have followed any specific treatment chart, which is usually suggested before considering any patient for surgery. This treatment chart is custom-made according to your symptoms and does follow the guidelines to treat both allergies with sinusitis. I would suggest: 1) Wear an N95 (non-oil) mask at all times, do not allow any dust or irritative substance from entering your nose. 2) Tablet Sinarest (Chlorpheniramine, Paracetamol, and Phenylephrine) or its equivalent, one tablet two times a day after food 12 hours apart for 15 days. 3) Tablet Allegra-M (Montelukast and Fexofenadine) or its equivalent, one tablet two times a day after food 12 hours apart for 15 days. 4) Tablet Zerodol TH (Aceclofenac and Thiocolchicoside) 4 mg, or (its equivalent) one tablet two times a day after food for five days. 5) Tablet Clarithromycin 500 mg one tablet two times a day after food 12 hours apart for 15 days. 6) Duonase nasal spray (Fluticasone propionate and Azelastine), or its equivalent two puffs two times a day in both nostrils for three months (do not inhale while you spray the drug). 7) Tablet Mucomix (Acetylcysteine) 600 mg (or its equivalent) one tablet two times a day 12 hours apart after food for one week. 8) Tablet Wysolone (Prednisolone) 10 mg one tablet after breakfast for one week. 9) Steam inhalations three to four times a day. 10) Saltwater gargles eight to ten times a day for one month. 11) Do not smoke or consume alcohol as it slows down mucociliary clearance mechanisms. Surgery can be considered (if the above medications and precautionary measures do not give any relief), but there is a catch to it. Even on a larger scale, the symptoms might sometimes come back after a brief relief following surgery if the preventive measures are not followed. Ideally speaking in a nutshell, I again emphasize preventing any irritative substance from entering the nose and throat, thereby triggering an allergic cascade of events and reproducing the symptoms you mentioned above. You need not worry about anything, once you follow the suggestions mentioned above, your symptoms should start coming down, and I am sure you will recover with time. I hope I have answered your query in detail. Please revert in case of further queries.