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CT scan showed mucosal thickening in bilateral frontal. What does it mean?

Answered by
Dr. Naveen Kumar

ENT Specialist

Practicing since :2001

Answered : 2356 Questions

Posted on Tue, 18 Dec 2012 in Ear, Nose and Throat Problems
Question: Report 1
Obliteration of bilateral omu and left enthmoid infundibulum with associated chronic ethmoidal, maxillary sinusistis
mild frontal and left sphenoidal sinusitis

Report 2
what does it mean mucosal thickening in bilateral frontal, maxilllary sphenoidal sinuses and ethmoid ear cells - s/o pansinusitis.

Answered by Dr. Naveen Kumar 3 hours later

Thanks for posting the query

All the information you have provided is about the CT scan findings of the nose and the paranasal sinuses. Let me explain to you what exactly theses structures are, so that, you will get an idea about this problem.

Paranasal means around or near your nose. Sinuses are the spaces or small tunnels. Paranasal sinuses consist of multiple, air filled spaces within the bones of your face, above and behind your nose and behind your cheekbones. They are meant to lighten the weight of your skull and assist in speech.

There are four groups of sinuses:
1.     Maxillary sinuses below your eyes and on either side of your nose
2.     Ethmoid sinuses situated above the root of the nose and between the eyes
3.     Frontal sinuses above the eyebrows, over the forehead
4.     Sphenoid sinuses behind the nose

Apart from the sinuses, there are three pairs of turbinates present inside the nose, situated along the side walls of the nasal cavities. They are stacked one above the other with a tunnel like structure in between. Turbinates are designated as lower, middle and upper. The function of the turbinates is to warm up the air which we inhale.

OMC (osteomeatal complex) is the name given to a group of structures containing middle turbinate, a tunnel like structure between the middle and lower known as middle meatus, a channel connecting the middle meatus into the maxillary sinus and ethmoidal sinuses known as infundibulum and finally another connection from the frontal sinus into the middle meatus.

The report mentions there is a block in this complex. Due to the blockage there will be stagnation of the secretions inside the frontal, ethmoidal and maxillary sinuses giving rise to various problems. If these sinuses become infected, for example when you have a cold, they fill with mucus and become blocked. This causes the pressure and pain around your nose and eyes when you have a cold (sinus pain).

Mucosal thickening in the sinuses refers to inflamed and swollen inner lining of these sinuses. This again is secondary to recurrent blockage of the sinuses.

All put together, this condition is called as chronic sinusitis. Initially, this condition is managed medically with oral medicines and local sprays. If the problem does not relieve with the medicines, then surgical intervention has to be done to remove the blockage and ventilate the sinuses.

My advice to you is:
1. To use steroid (such as Momentasone/ Fluticasone) nasal spray once a day. Steroids shrink the inflamed mucosa and helps in reliving the block.
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 drink plenty of warm water and to avoid chilled food/beverages and coffee.

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 : Dr. Chakravarthy Mazumdar
Follow up: Dr. Naveen Kumar 41 minutes later
Thanks for the reply, Can you please let me know permanent cure, because as you said this problem persist and will become more during the cold, you are exactly correct but now i don't have cold and i use fluticasone whenever nose gets blocked i took medicine but still my nose gets blocked when i asleep on one side which leads to heavy snoring this blockage shifts whichever side i fell asleep, i cannot use these sprays and medication continously, and i want to know if i undergo endoplasty what are the precautions i need to take after the surgery, and how much my daily job time will be wasted.
Answered by Dr. Naveen Kumar 4 hours later

Thanks for writing back

1. Can you please let me know permanent cure

A: If it is mere sinusitis then it can be treated effectively with medicines/surgery. But, if there is associated allergy, then the possibilities of recurrent sinusitis cannot be ruled out. Usually, Fluticasone is advised regularly for 6 months, once a day. If you are unable to tolerate then you can use saline spray 3-4 times a day, followed by steam inhalation, it will give very good results.

2. i want to know if i undergo endoplasty what are the precautions i need to take after the surgery, and how much my daily job time will be wasted.

A: Endoscopic sinus surgery is a preservative surgery, performed entirely inside the nose without any incisions from outside. As it is a conservative surgery, not many precautions are required. Post surgery, there will be packs paced inside your nose in order to maintain hemostasis. The pack will be removed within 24-48 hours. After that you will have to stay at home for 3-4 days. For a week or two, there will be nasal block due to presence of blood clots and swelling inside the nose which will gradually clear off with saline spray.

Hope you are satisfied with the response. Any more doubts you are welcome.

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

The User accepted the expert's answer

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