Chronic Sinusitis,cold,duonase Nasal Spray,x-ray
I am 30 YRS old and I have chronic sinusitis for past 5 years. I am easily get cached by cold every two months once. I am using duonase nasal spray and deslor tab every day. Recently in my x-ray report study shows that 1 bilateral inferior nasal turbinates hypertrophic 2 bilateral maxillary right frontal sinusitis for clinical correlation. What should I do? Any curable treatment.
Thank you for your query.
1. Get a plain CT PNS (Para Nasal Sinuses) scan with 1 mm coronal, axial and sagittal cuts done on a multislice CT Scan Machine. This is the gold standard imaging in chronic sinusitis. X-rays are only for screening.
2. There is a possibility that you have a mild form of Samter's Triad: Sinusitis/ tendency to asthma, Aspirin Allergy and maybe Nasal polyposis (not seen easily on X-rays). If you do not have any tendency to asthma or polyps, your condition will be easier to treat without recurrence.
3. Continue with your current medication. I would add an anti-leukotriene like montelukast 10 mg once a day. Also add regular saline nasal washes and steam inhalation.
4. A nasal endoscopy will help. Sometimes the infection is fungal and not bacterial.
5. You may share your CT/ X-ray images via YYYY@YYYY wih 'Attn: Dr. Sumit Bhatti' as the subject line or can also upload the images on the right side of the query box. Please do confirm the uploading or mailing of the images by writing here as to reply you back at the earliest.
5. If medical treatment fails, FESS (Functional Endoscopic Sinus Surgery) and Radio-Frequency Ablation of the Inferior Turbinates will help.
6. Aspirin desensitization may be attempted.
Hope I have answered your query. If you have any follow up queries I will be available to answer them.
Regards.