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Suggest Treatment For Chronic Sinus Infection
Question: can u please guide for chronic sinus infection,CT sinus and CT Corosal done , link enclosed .need detailed opinion for all the four sinus and corosal structure.
Does these are infections,inflammations,fungal ,polyps
Does these are infections,inflammations,fungal ,polyps
Brief Answer:
Biopsy can confirm polyps or fungus infection.
Detailed Answer:
Hello,
I have gone through the reports in detail.
There is opacification of both maxillary sinuses(right>left),ethmoid sinus and frontal sinus(left>right).
Sphenoid sinus appears normal.
There is also hypertrophy of inferior turbinates.
Opacification in maxillary,ethmoid and frontal sinus may be due to polyps or fungal infection.
There are also bony erosions in medial wall of maxillary sinus,it may indicate fungal etiology.
It is important to seen density of opacification.Fungal infections are hyperdense in CT scan.
In this condition,biopsy of lesions can be done and culture of material can be done.It can assess presence of fungal infection because treatment plan varies according to etiology.
You may need endoscopic examination for biopsy.
Get well soon.
Hope I have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Biopsy can confirm polyps or fungus infection.
Detailed Answer:
Hello,
I have gone through the reports in detail.
There is opacification of both maxillary sinuses(right>left),ethmoid sinus and frontal sinus(left>right).
Sphenoid sinus appears normal.
There is also hypertrophy of inferior turbinates.
Opacification in maxillary,ethmoid and frontal sinus may be due to polyps or fungal infection.
There are also bony erosions in medial wall of maxillary sinus,it may indicate fungal etiology.
It is important to seen density of opacification.Fungal infections are hyperdense in CT scan.
In this condition,biopsy of lesions can be done and culture of material can be done.It can assess presence of fungal infection because treatment plan varies according to etiology.
You may need endoscopic examination for biopsy.
Get well soon.
Hope I have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr XXXXXXX
1.Does you have read pictures of CT corosal as well.? do you see any thing serious in both CD,
2.Please name exactly for this sinusitis? here they are naming it chronic sinusitis, not accepting fungal infection, explaining that fungal can not be noticed on CT scans. pl clarify this, mention your tel.
WHAT IS BONY EROSION- looks these carry seriousness?
2.Here in Calgary ENT surgeon plan surgery Endoscopic Sinus surgery and septoplasty on April 6, 2015 does it is safe to wait up to that date.
Headache on center and sides of head with back of head .
3.Does there is any other test like blood/urine where we can check fungal infection like blood culture, here doctors are not ready to do either blood culture/tests nor biopsy, only depending on ENT surgeon.does this is safe and recommended.
4.Enclosing word copies of CT sinus and Corosal done by Radiologists in Calgary,please clarify these both reports for their correctness because here in calgary such reports are not much dependable and trustworthy.
They have mentioned in one of report that Spheroid is also effecting, please clarify and compare.
5.MRI of brain is enclosed. please guide- that does it is related to sinus concerns- asymmetry of pituitary- in this case also they are not interested to do dynamic MRI.
6. In next followup I will mention names of medicines/antibiotics/antifungal so far have taken. ENT surgeon prescribed Clarithromycin 500 mg one daily for 90 days /till surgery,what do you think for this?
1.Does you have read pictures of CT corosal as well.? do you see any thing serious in both CD,
2.Please name exactly for this sinusitis? here they are naming it chronic sinusitis, not accepting fungal infection, explaining that fungal can not be noticed on CT scans. pl clarify this, mention your tel.
WHAT IS BONY EROSION- looks these carry seriousness?
2.Here in Calgary ENT surgeon plan surgery Endoscopic Sinus surgery and septoplasty on April 6, 2015 does it is safe to wait up to that date.
Headache on center and sides of head with back of head .
3.Does there is any other test like blood/urine where we can check fungal infection like blood culture, here doctors are not ready to do either blood culture/tests nor biopsy, only depending on ENT surgeon.does this is safe and recommended.
4.Enclosing word copies of CT sinus and Corosal done by Radiologists in Calgary,please clarify these both reports for their correctness because here in calgary such reports are not much dependable and trustworthy.
They have mentioned in one of report that Spheroid is also effecting, please clarify and compare.
5.MRI of brain is enclosed. please guide- that does it is related to sinus concerns- asymmetry of pituitary- in this case also they are not interested to do dynamic MRI.
6. In next followup I will mention names of medicines/antibiotics/antifungal so far have taken. ENT surgeon prescribed Clarithromycin 500 mg one daily for 90 days /till surgery,what do you think for this?
Brief Answer:
Findings are not very serious.This is a manageable condition.
Detailed Answer:
Hello
Sorry for replying late.
Findings are not very serious.Definitely,basic cause is changes of chronic sinusitis.
Comment about fungal cause is based on hyperdensity in CT scan.Fungal infection is common in diabetic and immuno-compromised patients.But confirmation is only done by biopsy and histopathology.CT scan can only tell about possibility of fungal infection.
Mild bony erosions may be due to over expansion of sinuses,it is not a serious issue.
At this stage definitely you need endoscopic examination and surgery.You can wait up to april.
Headache may be due to sinusitis.Till surgery conservative treatment can be tried.
Sphenoid is minimally involved and this can be ignored.
MRI findings are not serious.Dynamic MRI depend upon evaluation.It is not urgent.
You can continue clarithromycin till surgery.
Get well soon.
Hope I have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Findings are not very serious.This is a manageable condition.
Detailed Answer:
Hello
Sorry for replying late.
Findings are not very serious.Definitely,basic cause is changes of chronic sinusitis.
Comment about fungal cause is based on hyperdensity in CT scan.Fungal infection is common in diabetic and immuno-compromised patients.But confirmation is only done by biopsy and histopathology.CT scan can only tell about possibility of fungal infection.
Mild bony erosions may be due to over expansion of sinuses,it is not a serious issue.
At this stage definitely you need endoscopic examination and surgery.You can wait up to april.
Headache may be due to sinusitis.Till surgery conservative treatment can be tried.
Sphenoid is minimally involved and this can be ignored.
MRI findings are not serious.Dynamic MRI depend upon evaluation.It is not urgent.
You can continue clarithromycin till surgery.
Get well soon.
Hope I have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Great Dr XXXXXXX
With your replies I got relief.
can you guide-
fungal infections affecting the paranasal sinuses: (1) acute or fulminant invasive fungal sinusitis, (2) chronic or indolent invasive fungal sinusitis, (3) fungus ball (mycetoma), and (4) allergic fungal sinusitis. Each type of infection has its own distinct presentation and therapy.
I may have suffering with-4) allergic fungal sinusitis,
As far as Sphneoid is concerned- as you said Sphenoid is minimal effected, you will find some explainations- on CT scan report, please co relate with those and film reading by you.
I am sure there must be some errors//mistakes/omissions/wrong interpretaions in the reports of CT Scan and CT Corosal made by Canadian Radiologists, because they are always releasing confusing reports, you can please mention those errors//differences as far as your learned readings of CT films.
Once a time in past they noticed fibroid in my CT abd, after three months waiting by specialists they issue addendum, even some time they issue wrong readings of ECO /ultrasound of heart reports . Your findings will guide me on right path. They are issuing such reports on voice interactive type manager which is on faroff/remote location and never read and sign reports, due to these blunders I am more intersted to have detailed clarifications from your end please.
With your replies I got relief.
can you guide-
fungal infections affecting the paranasal sinuses: (1) acute or fulminant invasive fungal sinusitis, (2) chronic or indolent invasive fungal sinusitis, (3) fungus ball (mycetoma), and (4) allergic fungal sinusitis. Each type of infection has its own distinct presentation and therapy.
I may have suffering with-4) allergic fungal sinusitis,
As far as Sphneoid is concerned- as you said Sphenoid is minimal effected, you will find some explainations- on CT scan report, please co relate with those and film reading by you.
I am sure there must be some errors//mistakes/omissions/wrong interpretaions in the reports of CT Scan and CT Corosal made by Canadian Radiologists, because they are always releasing confusing reports, you can please mention those errors//differences as far as your learned readings of CT films.
Once a time in past they noticed fibroid in my CT abd, after three months waiting by specialists they issue addendum, even some time they issue wrong readings of ECO /ultrasound of heart reports . Your findings will guide me on right path. They are issuing such reports on voice interactive type manager which is on faroff/remote location and never read and sign reports, due to these blunders I am more intersted to have detailed clarifications from your end please.
Brief Answer:
If it is fungal infection then it can be allergic fungal sinusitis.
Detailed Answer:
Hello
Yes,if it is fungal infection then it can be allergic fungal sinusitis.
CT scan can only comment on possibility of fungal infection,it is not confirmatory.
You don't worry bout this.There is no invasion to surroundings structures like eye ball,brain etc,so it is not an emergency.Simply it may also be changes of chronic sinusitis.Fungal infection is commented on hyperdensity in CT scan.There are also other findings associated with fungal infection and these are not present in your case,so you don't worry.
CT scan commented on small part of sphenoid sinus involvement which is not a major finding.
Get well soon.
Hope I have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
If it is fungal infection then it can be allergic fungal sinusitis.
Detailed Answer:
Hello
Yes,if it is fungal infection then it can be allergic fungal sinusitis.
CT scan can only comment on possibility of fungal infection,it is not confirmatory.
You don't worry bout this.There is no invasion to surroundings structures like eye ball,brain etc,so it is not an emergency.Simply it may also be changes of chronic sinusitis.Fungal infection is commented on hyperdensity in CT scan.There are also other findings associated with fungal infection and these are not present in your case,so you don't worry.
CT scan commented on small part of sphenoid sinus involvement which is not a major finding.
Get well soon.
Hope I have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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