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Suggest Treatment For Chronic Sinusitis

Posted on Wed, 1 Oct 2014

Question: History 28yr old female. No health problems. Some allergies, never bothered to much. Had flu in march. Started having pressure, dizziness and brain fog in may. Gp sent for CT of sinuses . Results were in XXXXXXX frontal sinus well aerated. The front ethmoid recesses are patented. There is trace anterior ethmoid sinus mucus thickening. Mild maxillary. Sinus mucus thickening . The ostiomeatal units obstructed. There is concha bullosa of the left turbinate with layering air fluid level. Mild rightward deviation of nasal septum. Impression mild maxillary and minimal ethmoid sinus disease and mild deviated septum. Rx Lebanon 10 days felt better , after about 10 days symptoms back. ENT then gave antibiotic for 7 days, came back. Sent for MRI with and without contrast, all normal. Another ENT gave antibiotic for 7 days, came back. All blood work perfect. When ENT spays decongestant to look up nose, feels good for some time, then back. Currently out of work 2 weeks waiting for dr blood test for Lyme (probably neg, but checking.). Obviously antibiotic did work but maybe need more time on it. What's next step for ENT, very desperate.

Answered by Dr. Deepashree (2 hours later)

Brief Answer:
obstructed osteomalacia complex, FESS advised

Detailed Answer:
Hi, thanks for your query.
You have mild DNS to right with obstructed OMC causing chronic sinusitis.
Treatment is antibiotics with decongestant tablet and nasal drops.
What your doctor has treated you is correct.
If symptoms are recurring, then it can be treated with steroid nasal spray . Saline doughing ,Neti pot and regular pranayama (breathing exercises) in yoga will help.
If still the symptoms recurring, then surgical correction of the deviated septum and surgical clearance of the sinuses (FESS).are recommended. Hope my answers have helped you. Pleased to help you further. Thanks.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Deepashree (15 hours later)

No antibiotics given since first week of august. Symptoms returned. Today have another scan of sinuses and head. Results tomorrow. What should I ask. I am deperate for answers Today I am nauseous . Why is it such a fight to get meds maybe for a longer time to see if it helps. I also need to go back to work, symptoms are. Pressure, foggy feeling, dizziness now a little nausea. Thanks

Answered by Dr. Deepashree (7 hours later)

Brief Answer:
review scan. condition of sinuses. fess.

Detailed Answer:
Hi, thanks for your follow up query.
Just wait for the scan results. Empirically you can take steam inhalation. Use decongestant nasal drops + decongestant tablet twice daily for 3 to 5 days.
Nothing can be advised without seeing the report.
Pleased to help you further. Thanks.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepashree (14 hours later)

Scan back of head. Cerebral hypotension. Now trying to find neurologist at NYU that can get us in before 2 months.
What is the treat,ENT for this? Can I go to work while waiting for appointment? How could this have happened?
Sinus scan not back yet

Answered by Dr. Deepashree (1 hour later)

Brief Answer:
Please reply back after sinus scan report.

Detailed Answer:
Hi, ir would better to consult with the neurologist for better medical evaluation.
There is no ENT causes for cerebral hypotension. Vascular pathology ,probably might be the cause.
Not much experience in this field.
Please get back after sinus scan report

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj