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Suggest treatment for persistent sinus infection and headaches

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Posted on Tue, 12 May 2015
Question: Hello, my boy who is 8 has been on five antibiotics for a sinus infection since January. The last week and half his headaches are getting worse, still running 100 degree temperature. He had a CT scan on Friday findings: Maxillary sinuses: large domed shaped soft tissue structure completely opacifying the entire right maxillary sinus and eroding through the medial wall of the right maxillary sinus. . Could represent a large polyp or mucous retention cyst...
Why hasn't this cleared up? Why is it eroding? Is it due too his CVID? Is surgery needed?
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Answered by Dr. Diptanshu Das (1 hour later)
Brief Answer:
ENT opinion required

Detailed Answer:
Thanks for asking on HealthcareMagic.

Sinusitis is a condition characterized by infection or inflammation of the sinuses which are air filled mucus membrane lined cavities in our head. The maxillary sinuses are located behind our cheeks. It is hard to comment based on the little description that you have provided. It would have really helped if I could see the CT Scan or its reporting. As such, it could indeed represent a large polyp which could be cause of the persistent infection. But the erosion worries me. You will have to talk to an ENT specialist to make sure that it is not cancerous although I find no reason to jump to the diagnosis of Common variable immunodeficiency (CVID). Cancerous tumors have the capacity to erode the walls, the capacity that is lacked by benign tumors or polyps. The ENT doctor will also be able to evaluate the further course of management. Surgery would most likely be needed.

Hope that helps.

Regards
Dr. Diptanshu Das
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Diptanshu Das

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Practicing since :2005

Answered : 3867 Questions

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Suggest treatment for persistent sinus infection and headaches

Brief Answer: ENT opinion required Detailed Answer: Thanks for asking on HealthcareMagic. Sinusitis is a condition characterized by infection or inflammation of the sinuses which are air filled mucus membrane lined cavities in our head. The maxillary sinuses are located behind our cheeks. It is hard to comment based on the little description that you have provided. It would have really helped if I could see the CT Scan or its reporting. As such, it could indeed represent a large polyp which could be cause of the persistent infection. But the erosion worries me. You will have to talk to an ENT specialist to make sure that it is not cancerous although I find no reason to jump to the diagnosis of Common variable immunodeficiency (CVID). Cancerous tumors have the capacity to erode the walls, the capacity that is lacked by benign tumors or polyps. The ENT doctor will also be able to evaluate the further course of management. Surgery would most likely be needed. Hope that helps. Regards Dr. Diptanshu Das