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Permanent cure for Sinusitis - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3632 Questions
User :   I had sinus surgery last year due to continual recurrent sinus infections. Post surgery things cleared up but now still have current infection after two courses of augmentin. I am flushing sinuses periodically with Med Rinse. What are my options now?
Doctor :   Hi,
User :   hi, you have read my statement and query?
Doctor :   Yes, i have gone through the query , i can help you
Doctor :   You may need to get an repeat endoscopy to see whether the sinus mucosa has regenerated
User :   are you an ENT and what are my options?
Doctor :   which is one of the complications of sinus surgery
Doctor :   I am a General Physician, I believe I can help you within my expertise and If required I shall recommend a specialist.
User :   let me copy and paste my email to my ent surgeon ok?
Doctor :   yes,
User :   I am sorry to bother you with this but you performed sinus surgery on me last year and I don't seem to ever be free of infection. My nose always has junk in it and when I sleep one side always closes up because of the continual drainage and it is never really clear, consequently this wakes me up just about every night. Also, when I breathe hard through my nose during my workouts both nostrils collapse and it is difficult to keep both open unless I scrunch up my nostrils. Usually, it is to difficult to continually do this so I just breathe through my mouth when I need to suck in a lot of air. I recently requested a refill on generic Augmentin which I have completed both courses and I still have infection. I am really confused and frustrated because 5- 10 years ago I never had any problems like this. Shortly after my surgery it seemed to be ok but until the swelling went down I couldn't really tell. You told me that it would take about a year for those cilia to grow back to take care of the natural flow of secretions and I don't know if they have or not but I still have problems and I don't know what my next step should be. I thought that after the surgery things would improve but it really hasn't. I still flush my sinuses quite regularly and I think it helps but I would like to be clear of these sinus problems. I have a hard time believing that I am dealing with allergies year round that are complicating this issue.
Doctor :   for temporary relief , you may apply nasal decongestant drops to reduce the congestion in the sinus by NASIVION decongestant drops about 8 to 10 drops into each nostril twice a day
User :   i am a pharmacist and i am aware of all the drugs to treat these problems and i am currently using fluticasone at bedtime and i don't want to start using oxymetazolone otc
Doctor :   yes, you can send him the same script
User :   what?
Doctor :   the mail
User :   what is the active ingredient in Nasivion
Doctor :   Its Metazolone compound
Doctor :   The XYLO derivative of metazolone
User :   i don't want to continue to treat my problem symptomatically, i want to solve the problem
Doctor :   yes, for the cure you may have to proceed wth an endoscopy and confirming the presence of the sinus mucosa and getting it removed by a second FESS surgery
Doctor :   this give an end to it
User :   FESS is what? prefontal sinuses? and also why are my sinuses collapsing when i breathe hard through my nose during hard workouts?
Doctor :   Functional Endoscopic Sinus Surgery
Doctor :   the sinus do not collapse , either the congestion in the mucosa of the sinus or filling up of the sinus with secretions will present with the problems you are having
User :   ok, i didn't mean sinuses, i meant that the tissue covering the nose seems to collapse and the only way to keep the air passages clear is to scrunch up my nose
Doctor :   ok, i still attribute to the congestion of the nasal mucosa
Doctor :   or even secretions can block the nasal passages
User :   ok, so before i had the surgery, the doctor put me on a month long course of augmentin 875 bid and a medrol dose pak to try and reduce the swelling. both didn't work and now i have infection. any thoughts to change anibiotic?
Doctor :   If you have other signs of infection like fever , Pain and excess secretions , then yes there might be chances if antibiotic is changed
Doctor :   but cannot assure the complete cure without recurrences
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