I'm 20 years old, female Since the last two years

Patient

Q: I'm 20 years old, female. Since the last two years I have had chronic head and facial pain on the left side on an almost daily basis. The pain is dull, of low to moderate intensity, which usually originates in the top of the back of the head on the left side and then eventually spreads to the area around the bridge of the nose and the cheek on the same side. This is accompanied by congestion and heaviness in the pain-affected areas but especially around the bridge of the nose and cheek, a post nasal drip-like feeling, and tightness in the forehead. Sometimes there're a deep, throbbing pain on my left temple and discomfort in my chin that tend to come and go. Pressing the point where the bridge of the nose and the forehead meet gives some relief from the sensation of pressure/tightness in the region. Once the pain and all its accompanying conditions onset, they usually persist throughout the day, but there're times when they go away on their own without any medication and then come back again the next day. In the course of these two years I have been on pain-killers, gabapentin, decongestants and analgesics but none of them have proved much effective. I don't have fever, nausea, difficulty in breathing, sneezing or runny nose.

On the suggestion of an ENT specialist I recently got a CT-scan of my PNS, which shows mildly deviated nasal septum towards the left and two small polyps arising from the floor of the left maxillary sinus. The doctor however said that these conditions are not causing my headache and prescribed fluticasone fuorate nasal spray to relieve the congestion and shrink the polyps. He is of the view that the headache is in all likelihood vascular in nature and recommended taking Vasograin at the onset of pain. Vasograin has proved to be effective to some extent; it gives relief from the pain for a day or two but the pain comes back when its effect subsides. The congestion/pressure also persists even after using the nasal spray for around three weeks.

I'm very confused as to what could possibly be causing all this and am desperate for permanent relief from this ordeal that I have been going through for such a long time. Are the pain and congestion/pressure actually being caused by the polyps and the deviated septum or are they being caused by something else?

Doctor

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