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What Does This CT Scan Report Indicate?

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Posted on Thu, 4 May 2017
Question: Hi Team,
I am 29 years old male.I have sinusitis problem since 10 years and also Deviated Nasal Septum. I have through the FESS(Functional endoscopic sinus surgery). Post surgery i felt good for some days. But when I moved XXXXXXX in Winter the problem again strike back. From then I'm using some Sinusitis Medication prescribed by ENT only. Due to relocation i have visited another ENT, after examining the doctor told me that the previous surgery was not done properly and prescribed below medication for 14 days and suggested for CT Scan post the 15 days course.
Pantoprazole 40 MG. (1-----0-----0)(On empty stomach for 10 days).
Cefuroxime Axetil 250 mg (1----0-----1)( 7 Days ).
Predmet (Methylprednisolone) 8 mg (1----0-----1)( 5 Days ).
Predmet (Methylprednisolone) 4 mg (1----0-----1)( 5 Days ).
Fexofenadine Hydrochloride and Montelukast tablets (fexofenadine hydrochloride 120 mg and montelukast 10 mg) (0----0-----1)( 15 Days).
After 15 days course when i done my CT Scan below is the report.
Investigation
CT PARANASAL SINUSES (PLAIN)
Technique
Helical Scan was performed through the paranasal sinuses.
Findings:
Synechiae is noted between the left inferior turbinate and nasal septum.
Evidence of septoplasty, left middle turbinectomy, bilateral infundibulectomy and uncinectomy.
Minimal mucosal thickening is noted in both maxillary sinuses and right posterior ethmoidal sinus.
Other sinuses are clear.
Bilateral inferior turbinates are normal.
The fronto- ethmoidal recess, fovea ethmoidalis, cribriform plate and crista galli appear normal.
Impression:
•     Synechiae BETWEEN THE LEFT INFERIOR TURBINATE AND NASAL SEPTUM.
•     MINIMAL MUCOSAL THICKENING IN BOTH MAXILLARY SINUSES AND RIGHT POSTERIOR ETHMOIDAL SINUS.
While taking the above medication for 15 days i felt very good like never before. I felt like my head is lightweighted. After 15 days in the follow up consultation ENT specialist suggested the below medication.
Singulair (MONTELUKAST SODIUM) 10 mg (0-------0--------1) ( 60 days).
Nasal Irrigation with NasoWash for 60 days atleast once in a week.
Now coming to my present problem i started getting sleepless night because dry mouth in night while trying to sleep. So, again i visited ENT and the doctor told me that i got some sort infection because of some food i have taken recently for which i am allergic. and suggested the following medication along with Nasal Irrigation.
Fexofenadine Hydrochloride and Montelukast tablets (fexofenadine hydrochloride 120 mg and montelukast 10 mg) (1----0-----0)( 7 Days).
Cefuroxime Axetil 250 mg (1----0-----1)( 7 Days ) (only in case of no improvement after trying the above tablet).
But I took Predmet (Methylprednisolone) 8 mg (1----0-----1) for the last 2 days(even the doctor didn't suggested this) and Cefuroxime Axetil 250 mg just 1 hour back.
Now i'm feeling fever(100.9 F) and body pains and pain in Sinus areas. Could someone told me any medicne for this body pains and headache because of sinus till i consult my ENT morning.
doctor
Answered by Dr. Sumit Bhatti (45 minutes later)
Brief Answer:
A single tablet should suffice till morning.

Detailed Answer:
Hi,

Thank you for your query.

1. You can take a single tablet containing paracetamol and ibuprofen; such as Tab. Combiflam or Tab. Ibugesic Plus (if you do not have asthma or if you have taken these before). This tablet should be taken after food (not on an empty stomach). Another option is a single tablet containing paracetamol and tramadol; such as Tab. Ultracet. This should help till morning.

2. If you upload images of the pre and post surgery CT scans , I will be able to help you better.

3. In general, surgery does not cure any preexisting allergy. In your case the points that come to mind are left middle turbinate removal, medication or weather induced nasal dryness and flare up of infection due to steroids.

4. Normal healing time post FESS (Functional Endoscopic Sinus Surgery) and Septoplasty is at least 4 to 6 weeks. Internal healing can take up to 4 to 6 months. Hence you should be patient for a few weeks more.

5. Get a deep nasal swab sent for bacterial and fungal culture with antibiotic sensitivity. A Hemogram should be done.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sumit Bhatti (49 minutes later)
Hi Doctor,

Thanks for the reply. Present i do have Combiflam and Ultracet . I didn't take any of these tablets before and moreover i had my dinner at 11'o clock. Could you please suggest the best and quick reliever between these two.
doctor
Answered by Dr. Sumit Bhatti (1 hour later)
Brief Answer:
Any of these is fine.

Detailed Answer:
Hi,

Thank you for writing back.

1. Any of these two tablets is fine. You can take the one that suits you better based on your past experience.

2. Eating one tablet within 4 to 6 hours of eating is fine. You can eat a couple of biscuits before taking the tablet.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
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. Raju A.T
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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What Does This CT Scan Report Indicate?

Brief Answer: A single tablet should suffice till morning. Detailed Answer: Hi, Thank you for your query. 1. You can take a single tablet containing paracetamol and ibuprofen; such as Tab. Combiflam or Tab. Ibugesic Plus (if you do not have asthma or if you have taken these before). This tablet should be taken after food (not on an empty stomach). Another option is a single tablet containing paracetamol and tramadol; such as Tab. Ultracet. This should help till morning. 2. If you upload images of the pre and post surgery CT scans , I will be able to help you better. 3. In general, surgery does not cure any preexisting allergy. In your case the points that come to mind are left middle turbinate removal, medication or weather induced nasal dryness and flare up of infection due to steroids. 4. Normal healing time post FESS (Functional Endoscopic Sinus Surgery) and Septoplasty is at least 4 to 6 weeks. Internal healing can take up to 4 to 6 months. Hence you should be patient for a few weeks more. 5. Get a deep nasal swab sent for bacterial and fungal culture with antibiotic sensitivity. A Hemogram should be done. I hope that I have answered your query. If you have any more questions I will be available to answer them. Regards.