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Frontal sinuses are hypoplastic - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3617 Questions
Doctor :   hi
Doctor :   how can i help you?
User :   Hi I have some questions regarding findings in a Sinus CT scan.
Doctor :   ok
Doctor :   proceed
User :   I can type the report from the radiologist
User :   please allow me a minute or two
Doctor :   sure
User :   Findings: The frontal sinuses are hypoplastic. The remainder of the paranasal sinuses are normally developed. The nasal septum is angulated to the right and deviated to the left anteriorly. More posteriorly it is midline in position. There are defects in teh medial wall of the maxillary antra bilaterally, with partial resection of the uncinate processes. The remainder of the osseous structures are intact. There are small bilateral Haller cells. Mild aeration of the vertical lamella of the right middle turbinate is present.
Doctor :   ok
Doctor :   Is this your ct scan report

User :   There is polypoid and nodular soft tissue within the floor of the right maxillary antrum which may represent a mucous retention cyst or polyp. Scant mucosal thickening is noted in the left maxillary antrum. The medial antrostomies are patent bilaterally. There has been a partial ethmoidectomy anteroriorly bilaterally. These orifices are also patent. The remainder of the paranasal sinuses are normally aerated.
User :   yes
User :   just a little more to go...
Doctor :   ok

User :   There are no air-fluid levels in the paranasal sinuses. The osseous structures of the skullbase, fovea ethmoidalis, cribriform plate and lamina papyracea are intact. The left fovea ethmoidalis is slightly more superior to the right by approximately 2-3mm. The orbits and nasopharynx are unremarkable. The visualized intracranial structures are within normal limits. There is calcification of the left palatine tonsil. The nasopharynx and parapharyngeal spaces are within normal limits. The buccal and masticator spaces are unremarkable.
Doctor :   ok
User :   That's it for the findings

Doctor :   Can you please provide me clinical features /symptoms
User :   My symptoms are chronic post nasal drip for years, with sinus surgery conducted 10 years ago (conditions have only worsened since). Allergy testing only came back positive for cat and dust mite. Symptoms are 24 / 7 and do not respond to medications or nasal irrigations.
Doctor :   ok
Doctor :   according to Ct scan
Doctor :   it is showing the polypoid growth in right maxillary antrum
Doctor :   it might be the cause for your symptoms apart from your allergy
Doctor :   Do you have any facial pain?
User :   no facial pain, maybe minor but only from the snorting needed to clear my sinuses every 10 - 20 seconds

Doctor :   ok
Doctor :   So you have post nasal drip for long time
User :   15 years probably

Doctor :   ok
User :   but keeps getting worse and I want to eliminate it once and for all
User :   it has had a significant impact on my life
Doctor :   ok
Doctor :   Do you know the allergen for what you are allergic
Doctor :   because the very important thing what you have to do is strict avoidance of allergen
Doctor :   Are you there?
User :   they only said cat

User :   and dust mites
Doctor :   ok
User :   but even avoiding those
User :   I have symptoms
User :   and allergy meds have no affect
User :   like zyrtec, claritin, singular, no effect
User :   unless I am exposed to those allergies
Doctor :   Have you taken any desensitizing injections for your allegrgy
User :   no injections
Doctor :   ok
Doctor :   when was your last visit to physician
Doctor :   what did he said regarding your condition?

User :   I went to an ENT (Otolaryngolist)

User :   about a month or so ago
Doctor :   okay
User :   She said "very drippy"
User :   when she looked in my sinuses
Doctor :   ok
User :   She recommended the allergy blood tests, CT Scan and to try 3 drugs at the same time
Doctor :   ok
User :   The 3 drugs were singular, zyrtec and a prescription spray
User :   Even with all 3, there was no improvement
Doctor :   ok
User :   I will have a follow up appointment in a few weeks to go over the test results but wanted some input first
Doctor :   did you call her back regarding your condition
Doctor :   ok
User :   not yet
Doctor :   ok
User :   she has been sent the reports though
Doctor :   YOu had your last checkup 1 month back
Doctor :   use this three drug combination for few more weeks
User :   ok
Doctor :   as they may take much time in chronic allergic patients like you
Doctor :   and try to avoid the allergens to maximum extent
Doctor :   and try home remedies whichever gives relie for your condition
User :   found nothing to give me relief yet
User :   sometimes chewing gum with alcohol in it may sometimes clear mucous from my throught
Doctor :   have you taken vapor therapy
User :   no have not tried vapor therapy
User :   well actually
Doctor :   ok
User :   I tried this once after reading about it on the internet
Doctor :   ok
User :   I took strong Apple Vinegar
User :   and microwaved it
User :   and tried inhaling through my nose
User :   gave a painfull sensation
User :   but not sure it helped much
Doctor :   ok ok
User :   sometimes spicy foods will clear the area for maybe 60 seconds
User :   but then it returns right after
Doctor :   ok
Doctor :   rather than come into direct contact with vapor , try to inhale it from a distance
User :   yes, this was the approach I tried

User :   not to drink it through my nose
User :   only the vapor
Doctor :   ok
Doctor :   ok
Doctor :   Be compliant to triple drug therapy
Doctor :   because they will reduce the inflammation, what is going on in your sinuses
User :   ok

User :   so that report suggests inflamation?
Doctor :   yes
User :   Is there anything that would need to be removed surgically or cauterized?
Doctor :   there is polypoidal growth in your right maxillary sinus which is the mucosal inflammation
Doctor :   most of the times they will get subside with medicine only
Doctor :   but if they would not respond to medicine then doctor will think about other options
User :   I should also mention that might right sinus has more trouble passing air, but my left sinuses is by far the biggest producer of mucous
Doctor :   but according to your ct scan report , there is excessive mucosal growth in your right maxillary sinus
Doctor :   which is also called as poly
Doctor :   p
User :   interesting, how possible is it that they got left and right mixed up?
User :   both have severe symptoms but my left is the most "drippy"
Doctor :   it would not occur
User :   ok
Doctor :   because left maxillary sinus and right maillay sinus are seperated by thich nasal septum and nasal mucosal layers
User :   ok
Doctor :   Is there anything else i can help with?
User :   I think there was only one instance where I felt mostly clear in my sinuses post surgery
Doctor :   ok
User :   The doctor removed stiches and dressings from my nose in the office a few days after
User :   and surgically removed a lot of mucous
Doctor :   Your chronic allergic condition makes you feel like this
User :   it felt much better
Doctor :   but be compliant to medication
User :   ok, I will try it for 2-3 weeks
User :   and miss no days
User :   then go back for another appointment
Doctor :   yes
Doctor :   thats good
User :   ok, thank you that is all for today
Doctor :   ok
Doctor :   thank you .
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.
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