question-icon

Suggest treatment for chronic sinusitis

default
Posted on Thu, 24 Apr 2014
Question: Results from my Dr, seeing an ent soon. But Dr didn't explain there is extensive mucosal thickening at the right maxillary sinus, with small pockets of aeration at the anterior aspect of the sinus. Minor mucosal thickening is also present at the right anterior ethmoidal air cells. The frontal sinuses, sphenoid sinus, left maxillary sinus, the remainder of the ethmoid air cells, mastoid air cells, and middle ear cavities appear normally aerated. No air-fluid levels, osseous destruction, periosteal reaction is seen. At the time of scanning, the right osteomeatal complex is completely opacified by soft tissue/fluid density material. The left osteomeatal complex is patent. Nasal septal deviation to the right is present. The sphenoid sinus is septated. The left anterior clinoid process is pneumatised. The TMJs appear normal. CONCLUSION: Near-complete opacification of the right maxillary sinus. Less pronounced sinonasal mucosal disease at the right anterior ethmoid air cells. No air-fluid levels, bony destruction, periosteal
doctor
Answered by Dr. Sumit Bhatti (33 minutes later)
Brief Answer: As below: Detailed Answer: Hi, Thank you for your query. 1. Mucosal thickening in the Right Maxillary and Right Anterior Ethmoid sinuses and opacification are very common findings suggesting a chronic sinusitis. 2. If you can upload the CT Scan images, I will be able to give you a more accurate opinion. 3. In this case, it is important to rule out an Antrochoanal polyp. A diagnostic nasal endoscopy will help. 4. First try at least 6-8 weeks of medical therapy. Only if maximum medical therapy fails, then surgical options may be considered. 5. To avoid treating a CT Scan finding, it is important to know the symptoms. If you have any further questions, I will be available to answer them. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sumit Bhatti (1 hour later)
Thankyou I don't have the CT scan with me but I have had it for quite a number of years to the point of removing my back teeth a few years ago, thinking it was my teeth causing the pain, which my dentist wasnt too happy about. I have constant headaches gum/facial pain, neck pain always on antibiotics, this time I demanded a CT . I am on a stronger dose of medication till I see the ENT in 4 weeks time. I am just worried about waiting so long now to see the ENT, butthe doctor I saw didnt really explain the results too me and just referred me on.
doctor
Answered by Dr. Sumit Bhatti (3 hours later)
Brief Answer: There is no cause for worry. Detailed Answer: Hi, Thank you for writing back. 1. Yes, you are correct in relating the sinusitis pain referred to the upper teeth, the back teeth being closely related to the floor of the Maxillary sinuses. 2. What now needs to be also ruled out is any Oro-antral fistula (communication between the teeth sockets and the Maxillary sinus). 3. If you medication settles the symptoms, no further treatment is necessary. 4. Common surgical intervention form persistent symptoms may include a limited FESS (Functional Endoscopic Sinus Surgery) with or without any polyp removal or the newer minimally invasive technique of Balloon Sinuplasty. 5. There is no harm in waiting for a few weeks. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2652 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for chronic sinusitis

Brief Answer: As below: Detailed Answer: Hi, Thank you for your query. 1. Mucosal thickening in the Right Maxillary and Right Anterior Ethmoid sinuses and opacification are very common findings suggesting a chronic sinusitis. 2. If you can upload the CT Scan images, I will be able to give you a more accurate opinion. 3. In this case, it is important to rule out an Antrochoanal polyp. A diagnostic nasal endoscopy will help. 4. First try at least 6-8 weeks of medical therapy. Only if maximum medical therapy fails, then surgical options may be considered. 5. To avoid treating a CT Scan finding, it is important to know the symptoms. If you have any further questions, I will be available to answer them. Regards.