Pressure in the head

[anton121]

Hallo,

Since january 2009 i am suffering from pressure in the head.
The worst period was between january and october 2009, but it is still
intense. The reason for this is for sure a problem in the sector "Ear,
Nose and Throat". The pressure comes from air that concentrates in the sinus holes..
It seems that the ventilation between these holes and the nose does not work
properly. Therfore too much air concentrates in these holes and pressure in the
head follows. The valve does not work. Air flows in one of the
sinuses but does not get out. There seems to be a small swelling in the depth of the nose.
How comes that dizziness goes together with sinusitis. What is the reasen for that?
What can be done?
And is this a dangerous Problem.  Is it possible that the air diffuses to the brain?

Greetings  

Anton

[anton121]

Hi,

What would be the best treatment for such a problem. Except Surgery.

Greetings

Anton

[anton121]

Hi,

There is one thing that i forgot to mention: When i take the underground railway,
the pressure in the ears and in the nose rises. That never happened before this problems started in early 2009. How is this to explain, isn`t this not unusual for sinusitis?

Grettings,

Anton

[anton121]

Hallo,

"Frequent valsalva manoeuvre"
Could this also happen to someone without any congenital defects?

Greetings

Anton

[OHNS2010]

Hi,

Pneumocephalus is a condition caused by trapping of the air in the cranial cavity. Pneumocephalus is most commonly caused by trauma (75%), followed by tumor, infection, and fistulas between intracranial cavity and external air spaces.

Trauma may be due to road accidents, or iatrogenic- caused during the surgical procedures inside the nasal cavity. The occurrence of fistulas has been attributed to congenital cranial bony defects. Even frequent valsalva manoeuvre, barotraumas in pilots and scuba divers are also implicated.

But, you do not have any symptoms of pneumocephalus, like constant headaches, double vision or altered sensorium. More over your CT scan is normal, if at all, you had any pneumocephalus it would have been definitely picked up by the scan.

Regards
OHNS2010

[anton121]

Hallo,

Thanks for the Discussion.
To finally come to a conclusion regarding the question if there may be a neurological problem. If the bony structures in the sinuses would not  tolerate this amount of pressure, this would perhaps lead to pneumocephalus?. What symptoms would be associated with a problem like that? The main symptom I have apart the pressure is dizziness. Both are not very intense, but very disturbing.

Greetings

Anton

[OHNS2010]

Hi,

Thanks, I really appreciate your advice. As you have rightly mentioned, whenever there is some birth defects any increase in the intracranial pressure will definitely give rise to CSF/ Endolymphatic leak from the inner ear.

But during the normal/deep breathing the amount of pressure generated in the nasal cavity is not very high so as to cause trauma to the middle ear/ inner ear. Well this pressure variation can definitely cause damage to the mucosa of the sinuses if at all there is any variation in the atmospheric pressure as it happens in Barotraumas.

Sinuses are the hollow bony structures lined by the mucosa, so it is difficult for the sinuses to get damaged during the normal breathing.

Regarding the CT scans, you rightly pointed out that many radiologists’ miss a minor defects or fracture, the reason being the particular defect not included in the normal sliced windows. Minor defects can only be picked up in the high resolution CT scan.

Thank you once again.

Regards
OHNS2010

[RadioAstronomyObserver]

  Just making some observations....

"The bony structures in the sinuses can definitely tolerate this amount of pressure"
   I don't necessarily like this statement...  I have a birth defect where the skull between the inner ear and the brain is either missing, broke through, or so super thin that it is pliable.  Possibly the better statement would be "under normal circumstances...."?

  And the CT...  Because a CT is one of the critical items needed to determine if we have this "hole", we have found that many Dr.s and sadly many specialists don't know how to read these scans as looking at old scans we found these holes with ease.  What's worse is that at the resolution we need, the structure of the auditory system jumps out and nearly bits you and they still can't navigate their way through the scans.

  Basically what I'm saying is, Never make "absolute" statements, and never trust with absolution what the person who reads the scans says.

[OHNS2010]

Hi,

When your CT scan shows that there is no obvious deformity or any other problems you need not worry much as there are no signs of dangerous diseases or malformations. Indeed you can also go for a diagnostic nasal endoscopy, but when your CT scan is normal I do not usually advocate any further investigations. Stop worrying the more you worry the more you become conscious about even smaller things. It is all in the way you think, rather than anything inside your nose. Good Luck.

Regards
OHNS2010

[anton121]

Hallo,

I have been to an ent specialist. But the only thing he saw was a swelling in the depth of the left nasal duct. In this area i can even feel there is a thickening that may be the reason why the air is withheld from streaming out. When there is to much air flown in the pressure in the head is getting more intense. Also in the left nasal duct. One time, when the pressure was extremely high, air flew out like a "fountain". One can hear the hissing.
Ct scan of the sinuses and the head did not show anything specific. So maybe it is real nothing dangerous. But the symptoms are frightening.
Are there other useful methods to examine the nasal duct.

Greetings,

Anton

[OHNS2010]

I do not think this is a dangerous problem. The pressure in the sinuses is because of the blockage of the sinuses. The bony structures in the sinuses can definitely tolerate this amount of pressure.

Dizziness is a unique symptom usually indicating that the infection or inflammation has moved to the middle ear.This happens via Eustachian tube that connects your throat to your middle ear where the external sounds are transmitted to the internal auditory system. The middle ear contains numerous nerves, muscles and small bones that are responsible for auditory and positional information processing.Irritation of the middle ear transmits unusual information to the vestibular apparatus, which when receiving noxious stimuli dizziness can occur.

Try with steam inhalations, saline nasal drops and drink plenty of warm water, if the symptoms persist, please do consult your ENT surgeon.

Regards
OHNS2010

[anton121]

Thanks for your answer,

But the question remains: Is this a dangerous problem, when.there is too much
air pressure in the - for example - sphenoid sinus. Are the bony structures robust enough.
And: Why does sinusitis lead to dizziness?

Greetings

Anton

[OHNS2010]

Hi,

By the way you have described the following, it seems, you must be having a deviated nasal septum or enlargement of the turbinates. It warrants a thorough examination from an ENT specialist. Till then try doing steam inhalations and instill saline nasal drops in the nose.

Regards
OHNS2010