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Continuous cold, done dual slice CT scan of PNS. Is it necessary to have endoscopy done to remove mucus?

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ENT Specialist
Practicing since : 2001
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Doctor ,I am writing this for my wife AAAAA.She had continuous cold for one week ,had met ENT doctor and had dual slice CT scan of PNS (report attached). Doctor is saying to have an endoscopy surgery (with general anesthesia) done to remove the mucus out from sinus affected area. Doctor ,my question is whether it is mandatory to go for a surgery or can it be cured by medication. Please reply (+0000 / YYYY@YYYY )
Posted Fri, 28 Sep 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 1 hour later


Thanks for the query

The symptoms you have described are the features of Allergic rhinosinusitis.

Allergic rhinitis is a common condition characterized by an immunoglobulin E (IgE)-mediated inflammation of the nasal mucosa following exposure to allergens. It is characterized by sneezing, nasal discharge and nasal congestion.

During allergic rhinitis there is inflammation of the nasal mucosa causing blockage of the sinus openings leading to accumulation of the nasal secretions in the sinus. Also, there is trickling of the nasal secretions behind the throat causing throat discomfort and cough.

The common triggerers of allergy are the pollen, dust, fumes, coils smoke, etc. The bitter truth is, there is no cure for allergy, and only the preventive measures when followed can get rid of allergy.

Preventive measures such as avoiding the triggering allergens such as dust, smoke, strong perfumes and changing the pillow cover every night before going to bed can reduce the further attacks. Also, avoid sleeping directly under the fan or in front of the air conditioner.

Now, let’s discuss about the CT scan report:
There is osteomeatal complex (OMC)block on both the sides. Which means the opening of the maxillary, anterior ethmoidal and frontal sinuses are all blocked that can trap the secretions, raise the pressure in the sinuses and cause headache.

This OMC has to be opened up in order to ensure free drainage of the sinus secretions. I do feel there is no need of surgery at this stage because the nose is not treated adequately and not all the medicines prescribed are appropriate for this condition.

Wait for few months; once you start using the correct medicines, the problem might resolve and surgery would not be required.

My advice to her is:
1. To continue steroid (momentasone) nasal spray once a day.
2. To use saline nasal spray followed by steam inhalation 3-4 times a day, this will help in opening of the sinuses and easy clearance of the sinus secretions.
3. To use a mucolytic such as Bromhexine and Ambroxol, this helps in thinning of the tenacious secretions.
4. To change the antibiotic Formic XL. Instead, use either a combination of Amoxycillin and Clavulanic acid or Cefuroxime, the former and the latter are the drugs of choice for this condition.
5. To drink plenty of warm water and to avoid chilled food or beverages and coffee.
6. To Continue taking Thyronorm and Montair FX.

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
Follow-up: Continuous cold, done dual slice CT scan of PNS. Is it necessary to have endoscopy done to remove mucus? 27 minutes later
Thank you very much doctor for your prompt and explanatory reply.
I have discussed with my wife to do what you have suggested to get away from allergy.
Really thankful,
Answered by Dr. Naveen Kumar 7 minutes later

Welcome back

I wish her a good health. All the best.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
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