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Diagnosed with sinus problems. Had CT Scan. What are the findings and treatment?

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ENT Specialist
Practicing since : 2006
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I have been diagnosed with sinus problems. Can you please take a look and tell me what you see in my CT SCAN?
Hi I have uploaded my CT SCAN as a slowed down video to youtube here
Can you also give me an idea about recommended treatment?
Posted Mon, 2 Sep 2013 in Ear, Nose and Throat Problems
Answered by Dr. Hariom Sharma 1 hour later
Brief Answer:
Left Maxillary Sinus polyp

Detailed Answer:
Thanks for your query
From the video submitted by you it looks like you are suffering from left maxillary sinusitis .
The information from your CT scan video are:
Both Frontal Sinus clear.
Bilateral Ethmoid sinus clear
Right maxillary sinus mild mucosal thickening .
Left maxillary sinus- polypoidal growth present .
Sphenoid sinus clear.
Septum within normal limit.

I usually prescribe a tapering dose of steroid, antibiotics, anti-allergic and nasal decongestant, in such a scenario.

In case of any doubt, I will be available to answer them.
Wish you good health
Above answer was peer-reviewed by
Follow-up: Diagnosed with sinus problems. Had CT Scan. What are the findings and treatment? 1 hour later
First. Sincerely, Thank You very much for the incredibly detailed response.

I have been on a steroid spray for 1.5 weeks. I told my first HNO(ENT) that this doesn't appear to be doing anything. So he told me to quit taking it. He then recommended surgery to remove one cyst and one polyp.

I then scheduled an appointment at a different hospital for a second opinion ENT. The second ENT used a scope that went through my nose into my throat where he then made me say "hmmmm". He reviewed my CT and quickly told me that I need surgery of a cyst and two polyps.

After reviewing the physical comfort level of the hospital, I began looking for a more comfortable hospital with Air Conditioning for the surgery.

I then received a different third opinion from a doctor at a more comfortable privately funded hospital. The third doctor reviewed my CT scan with me and pointed out a cyst and a polyp. He then did a quick scope into my mouth and said I need surgery to correct this problem, but first he wanted me to start using Nasonex while he was on vacation for the next two weeks. I have used it for two weeks and it seems to open up my sinuses a little.
The surgeon then referred me to his receptionist to schedule a time for surgery and insisted that I spend 4 days in the hospital. I contacted him later to discuss the procedure and get my insurance directly in contact with him. He then told me via email that all that I have is a polyp and no cyst.

I have had three surgeons recommend surgery. This concerns me greatly. The most concerning facts for me about sinus surgery are:

1. We have not exhausted all other non surgical methods prior to surgery.
2. There will be a significant amount of initial pain.
3. The Surgery can be quite XXXXXXX and could result in the loss of brain fluid or meningitis.
4. The side effects from getting the surgery will stop me from downhill snow skiing due to large amounts of cold wind rushing into my nose and causing pain.

Should I be concerned about the items above?

I know this is a lot to answer and I am very, very grateful.
Can you also tell me how much, how often and of what type of steroid, antibiotics, anti-allergic and nasal decongestant you would recommend?

As a side note: I am privately insured with excellent private insurance and I currently located in Germany a country where most of the patients are taken care of through government provided social medicine. I must pay the physicians directly as I am not covered under social medicine.

Sincerely Thank You very much,

Answered by Dr. Hariom Sharma 46 minutes later
Thanks for your follow up query
From your information provided ,I will suggests to you that first go for proper conservative treatment . If not resolved by this treatment and disease hampered your routine activity then you may go for surgery.

I usually prescribe the following to my patients:
A steroid for example prednisolone three times a day for first 7 days ,after that two times a day for next 7 days, after that once a day for next 7 days
An antibiotic like levofloxacin once a day for 7 days
Tablet Allegra 120mg for 21 days
Otrivin nasal drop 3 drops 3 times a day for 5 days after that nasal steroid for next 16 days.

If you have any doubt, I will available for your query.
Wish you good health.

Above answer was peer-reviewed by
Follow-up: Diagnosed with sinus problems. Had CT Scan. What are the findings and treatment? 1 hour later
I think a conservative approach is a great idea. :-)

I was already on levofloxacin for 7 days.

Should I be using the Nasonex at the moment?

If so, can I use the Nasonex and Steroid at the same time?

Thank You. Again.
Answered by Dr. Hariom Sharma 20 minutes later

Thanks for your follow up query

Ya, conservative approach is best.
You can use the nasonex and steroid at the same time.
But if you have the history of hypertension and diabetes then before using the steroid , please consult the your physician.

If you have any doubt , I will be available for your query.

Wish you good health
Above answer was peer-reviewed by
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