Why is my left maxillary sinus so inflamed?

[nialldev]

I have had allergy problems all my like, and recurrent sinusitus.  Had 24 i had septoplastic surgery done and a little reshape of inside to allow greater drainage.  This worked very well, however over the past few months my symptoms seem to be re-appearing. Facial Pain at maxillary sinus area with allergic rhinitis symptoms.  This started in september, and it feels like there is something in my sinus that i cannot remove.  Having experienced this before i started treating the allergy, nasal steroids ( Nasonex ) and antihistamines (Zirtek).  My doctor prescribed antibiotic to clear any illness if it could be present however this allowed no relief.  There is congestion but it is not an infection per sey.  I have very bad nasal drip which is causing sleep apnea, i wake numerous times at night choking coughing, my chest is wheezy but can be cleared, i have never had chest or asthma problems previously.  I have been treated with neoclarityn and an inhaler to no effect.  Again i refer to the left maxillary, i feel alot of pressure here, against my eye and teeth and the airway is not working proper.  Last week i had an xray done ( the beginning of further investigation )  and the radiographer remarked that there was opacification of left maxillary, with no air fluid level and symptomatic of sinusitis. Ethnoid, frontal and right mxillary unremarkable.  My bloods showed reactive lymphocitosis.
As i mentioned my symptoms seem to be worsening, i have not slept proper now in 3 days, and unless i take steroids and loads of medication i cannot sleep.  I had to stop the steroids, and last night again i could not sleep, i was choking so i attended my local accident and emergency, and was given yet more steroids.  While there he performed an endoscopy and remarked that the wall of my sinus looked inflamed.  I have now been given an appointment for a ct scan, and sent home with a bag of snortable liquid drugs.  This includes two steroids, one drop form and the other a suspension spray, a saline wash and otrivine ( xylometazoline ).  I was told that this should reduce the conjestion and drip to allow me to sleep.(it is now 36 hours since i have slept )  I started with the decongestant, then the steroid drop and after a bit i did the saline wash.  I hoped to reduce swelling and congestion to allow me to clean out with the wash.  I have trouble gettin anything down the left sinus without manipulating the position of the nose and sinus. The saline wash moved cleanly through the right, the left side retained half what i spuirted into it for about ten minutes before dripping back out.  Having taken so much decongestants and steroid sprays the nose still feels blocked however there is greater air movement which should just about facilitate sleep.  My questions are:
1.       Why am i having problems with just one sinus if it appears to be allergic rhinitis?
2.       The doctor remarked it was not good i had surgery previous, why?
3.       Is Lymphocytosis linked with sinus problems?
4.       I have read about a treatment where an air canal is put through the ear, would this help in anyway?
5.       In there is infection of the sinus wall, what are the treatment options?

I would be grateful for any advice or if anyone has experienced this and can help me in anyway.  It is starting to worry me becuase my airway is being compromised by something either growing or inflamed in my sinus.  Hopefully i will sleep and it will be all better but after 6 months of symptoms i know this is not just sinusitis, something else is going on.


Sinus sufferer :(

[Vigian]

Hi Friggy,

What do you think about "Ayr" saline product?  

[friggy]

There may or may not be something causing a blockage in there, or maybe just the inflammation, and it's best to let the doctors find it and do what they deem fit to do.  Good luck.

[nialldev]

Hi Friggy,

Thanks for replying, i am using the nasal saline wash and have now been told to stop because it gets lodged in the maxillary,there is no instant drainage, and this is after i have taken all the anti inflamation medication.  I can feel the water in my ear swooshing around, my head gets dizzy and i cant move.  It cleared the right perfectly, and as a product i like it but i need to sort some other problem first.  I have to return to hospital tomorrow to get oral treatment ( the sprays mentioned above are more than likely lodging and giving me post nasal drip, causing sleep apnea )  I am managing my symptoms and will start antibiotic treatment again tomorrow, i know this will probably help drainage now, but not long term.

Finger crossed i will sleep tonight before i visit casualty again,


Niall

[friggy]

The sinus wall doesn't usually get infected, but rather irritated and inflamed by infected mucus, which could have a cocktail of bacteria, viruses, and fungi, and may not respond to antibiotics.  Sinus rinses are lame, due to gravity.  I invented the Sinus Flush, which will use gravity to wash out all microbes in all the sinuses.  

http://www.medhelp.org/user_journals/show/2322

The Flip-Turn Sinus Flush is mildly risky, because you have to bend over to do it, preferably in a shower, but you can also do it outside on soft ground.

If you decide to try it, make sure the saline is hypertonic, rather than the weaker isotonic.

In my case, I flushed out a fungal structure that felt similar to the obstruction you feel, but that may not be the case with you.  At any rate, if you get no relief, then you can pursue other courses than chronic infection.