Hello and welcome to HCM,
The CT scan
findings of muco-periosteal thickening of the paranasal sinus and air fluid levels in the sphenoid
sinus suggests a chronic inflammation in the para-nasal sinus and acute infection in the sphenoid sinus.
A culture of the fluid accumulated in the sphenoid sinus will isolate the infectious organism and thus, help to plan the antibiotic drug.
You have mentioned that you have an eustachian tube dysfunction
. The ear communicates with the nasal cavity
via eustachian tube, and in turn the nasal cavity communicates with the para-nasal sinuses
The long history of the eustachian tube defect has led to a chronic inflammatory process in the para-nasal sinuses.
The treatment of choice is correction of the structural defect (if any) in the eustachian tube.
Consult your treating doctor for further details.
The immediate management is the clearance of infection with antibiotics.
I hope my answer is of help to you.
Thanks and take care.
Dr Shailja P Wahal