<s>[INST] Hi doctor, For about four months I have had painful facial, sinus headaches, fullness and fluid in both ears and bouts of vertigo and blurred vision. I have no mucus from the nose and had no recent colds or URI. My doctor prescribed antibiotics for ear infection and Flonase and Cetirizine for allergies and inflammation. Symptoms improved for a short time but then came right back. My GP ordered a CT scan of the sinus and no fluid or sinus infection was seen, but I have mucosal retention cyst in the left sphenoid sinus and a nasal septal spur, deviation to the left. The headaches are almost constant and causes fatigue and eye strain. I have tried neti pots, steam, Ibuprofen and I only get minimal relief. I am not sure what to try next. [/INST] Hi. The problem you are suggesting is facial headaches which may be due to many reasons: 1. Is this headache on one side of the face or on both the sides of face? Usually, sinusitis is presented on both sides and migraine presents on one side. 2. Please upload the scan to see the disease, sphenoidal retention cyst may not always present with headaches and if it is fungal ball in sphenoid, it can definitively cause headaches and has to be approached immidiately. 3. How often do you have symptoms of allergy like sneezing, nasal discharge, watering of eyes? The above answers will help us to come to a conclusion and also will let me give you a permanent closure to the problem. </s>