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Suggest treatment for chronic sinusitis

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Posted on Wed, 13 May 2015
Question: I have had what I thought was a swollen lymph node in my neck under my jaw for a year. It's feels about the size if a XXXXXXX and is rock hard and does not move. My doctor has felt for it 2 times and said he doesn't feel anything and if it hasn't gotten bigger don't worry about it. I also have chronic sinuses year around. Could this be cancer
doctor
Answered by Dr. Sumit Bhatti (34 minutes later)
Brief Answer:
USG Neck, FNAC. Not likely to be cancerous.

Detailed Answer:
Hi,

Thank you for your query.

1. Get a Neck Ultrasound (USG) done. This will confirm whether this swelling is a lymph node or a part of the sub-mandibular salivary gland and the exact size.

2. Usually sub-centimeter sized lymph nodes are considered reactive (not significant). If this swelling is the size of a XXXXXXX it must be larger than one centimeter and hence warrants attention.

3. This is probably due to chronic sinusitis. An FNAC (Fine Needle Aspiration Cytology) can be done to settle the diagnosis, sometimes USG guided if necessary.

4. This unlikely to be cancer as it has been there for a year. There are about 300 interconnected lymph nodes in the head & neck region alone and they would progressively enlarge if there was a cancer.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Follow up: Dr. Sumit Bhatti (34 minutes later)
Ok thanks sir it does not cause me any symptoms I just worry a lot and found it but it has been the same spot for a year I got blood work last May for a check up and all was good
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Answered by Dr. Sumit Bhatti (14 minutes later)
Brief Answer:
There is no cause for worry.

Detailed Answer:
Hi,

Thank you for writing back.

1. Since you have noticed it and it troubles you, get the USG and FNAC done.

2. This will settle the issue once and for all.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Follow up: Dr. Sumit Bhatti (2 hours later)
You don't think it's cancer though tight
doctor
Answered by Dr. Sumit Bhatti (13 hours later)
Brief Answer:
No. Absolutely not.

Detailed Answer:
Hi,

Thank you for writing back.

1. No Absolutely not.

2. I treat head & neck cancer patients and this is cannot be an aggressive cancer since it has been there for over a year.

3. The above investigations will settle the diagnosis.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Follow up: Dr. Sumit Bhatti (2 hours later)
Thanks sir also for the last 16 months sometimes I'll randomly spit or suck my throat and spit and it's tinted red. I have bad sinuses year around. After I spit a few times it returns to normal. It hadn't gotten any worse. Sometimes when I drink beer I'll suck my throat a notice it. Could this be just sinuses.
doctor
Answered by Dr. Sumit Bhatti (4 hours later)
Brief Answer:
PND leads to Granular Pharyngitis which may cause blood stained sputum.

Detailed Answer:
Hi,

Thank you for writing back.

1. Chronic Sinusitis in many people leads to a Post Nasal Drip (PND). This PND infects the lymphoid tissue scattered throughout the throat.

2. This lymphoid tissue is delicate and easily bleeds on coughing, spitting or sucking on the throat. The other common causes include nasal bleeding (due to the chronic sinusitis), dental inflammation and Vitamin C deficiency (especially if you have any exposure to tobacco). Rule out any acid reflux.

3. Hence an occasional blood stained sputum. Get the sputum examined on three successive days for bacterial culture (including AFB-Acid Fast Bacilli) and occult blood.

4. Repeat routine blood tests and compare them with the ones last May. Get a Dental and ENT check-up (preferably with a Nasal Endoscopy & a VideoLaryngoScopy) and start multi-vitamin supplements (including Vitamin C).

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumit Bhatti (23 minutes later)
So again not cancer since it's been there for 16 months
I also chew skoal
doctor
Answered by Dr. Sumit Bhatti (22 hours later)
Brief Answer:
Yes, it is not likely to be cancer. Stop further use of Skoal.

Detailed Answer:
Hi,

Thank you for writing back.

1. Yes, it is not likely to be cancer since it has been there for more than a year.

2. You should stop using Skoal as it is a tobacco based product. A few years after stopping this your risk of developing a cancer will drop to that of a non-user.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumit Bhatti (1 hour later)
Ok thanks sir I have no cancer in my family but I worry about it a lot
doctor
Answered by Dr. Sumit Bhatti (3 minutes later)
Brief Answer:
Your risk for cancer is very low. Keep a regular follow-up.

Detailed Answer:
Hi,

Thank you for writing back.

1. Your risk for cancer is very low.

2. Do get regular follow up done regarding these symptoms.

Wishing you good health.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2639 Questions

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Suggest treatment for chronic sinusitis

Brief Answer: USG Neck, FNAC. Not likely to be cancerous. Detailed Answer: Hi, Thank you for your query. 1. Get a Neck Ultrasound (USG) done. This will confirm whether this swelling is a lymph node or a part of the sub-mandibular salivary gland and the exact size. 2. Usually sub-centimeter sized lymph nodes are considered reactive (not significant). If this swelling is the size of a XXXXXXX it must be larger than one centimeter and hence warrants attention. 3. This is probably due to chronic sinusitis. An FNAC (Fine Needle Aspiration Cytology) can be done to settle the diagnosis, sometimes USG guided if necessary. 4. This unlikely to be cancer as it has been there for a year. There are about 300 interconnected lymph nodes in the head & neck region alone and they would progressively enlarge if there was a cancer. I hope that I have answered your query. If you have any more questions I will be available to answer them. Regards.