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Extensive mucoperiosteal thickening throughout the visible paranasal sinuses and air-fluid levels in the right sphenoid sinus. Help?

After having a CT scan done to see what is going on behind my ear drum. (I have had 5 tubes put in my ear drum in the last 5 years because my eustachian tube does not drain the liquid properly). They found extensive mucoperiosteal thickening throughout the visible paranasal sinuses and air-fluid levels in the right sphenoid sinus. They took a culture yesterday because the ear got infected again from the tube I had put in 2 months ago(this is the 3rd infection). They stated they will probably have to remove the tube and then we will decide what to do about the draining issue. Should I be worried about all of this? The Dr. doesn't seem to be but after looking online I'm finding all kinds of problems that can result from what I have going on in my sinuses and mastoids. Should I be having surgery to correct these issues?
Asked On : Mon, 8 Apr 2013
Answers:  1 Views:  355
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,

The CT scan findings of muco-periosteal thickening of the paranasal sinus and air fluid levels in the sphenoid sinus suggests a chronic inflammation in the para-nasal sinus and acute infection in the sphenoid sinus.
A culture of the fluid accumulated in the sphenoid sinus will isolate the infectious organism and thus, help to plan the antibiotic drug.

You have mentioned that you have an eustachian tube dysfunction. The ear communicates with the nasal cavity via eustachian tube, and in turn the nasal cavity communicates with the para-nasal sinuses.
The long history of the eustachian tube defect has led to a chronic inflammatory process in the para-nasal sinuses.

The treatment of choice is correction of the structural defect (if any) in the eustachian tube.
Consult your treating doctor for further details.
The immediate management is the clearance of infection with antibiotics.

I hope my answer is of help to you.
Thanks and take care.
Dr Shailja P Wahal
Answered: Mon, 8 Apr 2013
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