From the Guidelines
For a deviated septum with chronic sinus pressure and new right ear pain, I strongly recommend continuing follow-up with your ENT specialist to evaluate the need for surgical correction (septoplasty) and starting symptomatic relief measures as outlined below. The patient's symptoms can be managed with a combination of medications and lifestyle changes.
- Use a saline nasal spray 3-4 times daily to moisturize nasal passages and thin mucus, as recommended by 1 and 1.
- Take an over-the-counter nasal steroid spray like fluticasone (Flonase) or mometasone (Nasonex) once daily to reduce inflammation, as suggested by 1 and 1.
- For pain and pressure, try ibuprofen 400-600mg every 6-8 hours or acetaminophen 500-1000mg every 6 hours as needed, as recommended by 1 and 1. The new ear pain could indicate eustachian tube dysfunction related to your sinus issues, possibly requiring antibiotics if infection is present, as discussed in 1 and 1. Using a warm compress on the affected ear and sinuses for 10-15 minutes several times daily may provide relief. Avoid environmental irritants, stay hydrated, and consider using a humidifier at night. If symptoms worsen, especially the ear pain, return to your ENT promptly as this could indicate spreading infection requiring more aggressive treatment, as recommended by 1 and 1. The connection between your deviated septum, sinus pressure, and ear pain stems from the shared drainage pathways in your head, where obstruction in one area can create problems throughout the connected systems. It is essential to note that the patient's condition should be regularly assessed, and the treatment plan should be adjusted accordingly, as suggested by 1 and 1.
From the Research
Treatment for Deviated Septum and Chronic Sinus Pressure
- The treatment for deviated septum and chronic sinus pressure may involve septoplasty to relieve nasal obstruction and improve surgical access to the ethmoid sinus 2.
- However, the relationship between septal deviation and chronic sinusitis is not well established, and septal surgery may not necessarily improve postoperative prognosis or subjective comfort of patients 2.
- Studies have shown that deviated nasal septum can cause obstruction at the ostiomeatal complex, leading to an increased incidence and severity of bilateral chronic sinus disease 3.
Treatment for New R Ear Pain
- The treatment for new R ear pain may involve antimicrobial agents, such as amoxicillin-clavulanate, which has been shown to be effective in eradicating Streptococcus pneumoniae from the culture 4.
- However, the efficacy of amoxicillin-clavulanate compared to other antimicrobials or placebo may vary, and the rates of AOM relapse after treatment with amoxicillin-clavulanate were comparable to those of other antimicrobials or placebo 4.
- Middle ear pressure has been shown to correlate with the degree of nasal obstruction secondary to a deviated nasal septum, and septal surgery may improve middle ear pressure 5.
ENT Evaluation and Treatment
- An ENT evaluation is necessary to determine the best course of treatment for deviated septum, chronic sinus pressure, and new R ear pain.
- The evaluation may involve nasal endoscopy and computed tomographic (CT) imaging to assess the degree of septal deviation and its impact on the lateral wall of the nose and sinuses 3.
- Treatment may involve a combination of septoplasty, antimicrobial agents, and other therapies to address the underlying causes of symptoms 2, 4, 3, 5.