Hi folks,
Long time since I've posted.....puter been down....finally got another.
My ent is sending me to a larger medical center for treatment of my sinus issues. I am diabetic and I suppose he isn't comfortable treating me.
the CT results are so confusing...usually I can key in on certain words and make some sense of it....but not this one! Here goes...sorry it's a long one.

On the right.
There is moderate mucosal thickening of the inferior right maxillary floor with 40% opacification of the right maxillary sinus. The right ostiomeatal complex is patent. there is a concha bullosa in the vertical support of the right middle turbinate. The nasal passages are patent. Within the right sphenoid sinus is a bubbly air-fluid level.

On the left.
There is a bubbly air-fluid level in the maxillary which is 90% opacified. The left ostioeatal complex appears patent.
Anteriorly, the nasal septum deviates 2 mm to the left with an additional 2mm bony spur at the apex at the level of the left middle meatus which is patent.
The medial walls of the carotid canals at the posterior aspect of the sphenoid sinuses are coverd with bones.
I left out anything that was said to be normal....which wasn't much....
Any ideas???? I have heard some really rotten things about sinus surgery and being diabetic and have had MRSA twice already.... i am more than little concerned about this.
Thanks, Robin

I basically says you have moderate sinus disease and endoscopic surgery is appropriate. However, the reasons for your Dr referring you elsewhere is due to the higher risk of complications from diabetes (extended healing time) hence infection. He is wise to do so. My advise is to seek an otolaryngologist that specializes and board certified not only in ENT, but full-blown head and neck surgery including cancer etc. These are usually the cream of the crop. If you can find one who is also a clinical professor at a university medical school, all the better as they have seen it all. Of course, if your diabetes is poorly controlled or with other major complication, you may have a tough time finding anyone to risk it. Its no walk in the park even for non-diabetics. Best of luck with this.

Tex- Read my post about sinus surgery....One of the more recent threads. Don't mean to scare you, but I'd put it off as long as possible. Unless you have some MAJOR issue or an infection that won't heal, I'd avoid it for now. As I posted in the other thread, once they go in and cut, drill, & etc., things just aren't the same. Good luck!

texredbird-

I have a couple of different perspectives from what Executor and Naklang share.

First of all, you CT scan results mean the following:

-Your right maxillary sinus (in your cheek area) is 40% blocked (opacified) and there is some fluid/mucus in the right sphenoid sinus (behind your nose near the middle of your head).
-The rest of the nasal passages on the right side are healthy and open (patent)
-The left maxillary sinus is 90% blocked and you have some bony abnormalities that may impact your sinuses' ability to drain properly.

I would take Naklang's advice on finding a surgeon one step further - if you're going to a major medical focus on finding an ENT who specializes in treating chronic sinusitis, not just one who is board certified in head and neck surgery. Sinus surgery is very tricky and the pre-op and post-operative care you receive will have a big impact on the success of the surgery.

As for Executor's advice, I'm not sure avoiding surgery is a very good idea because these symptoms rarely if ever go away without some kind of intervention. The two key things are 1. Be sure they try all of the medical options that are available before you choose surgery and 2. Make sure the surgeon does less rather than more - hopefully you can find a surgeon who's goal is to return your sinuses to normal function with minimal surgery.

Just curious - where are they sending you?

Good luck to you!

Thanks for the replies! I have had several rounds of various antibioics.....then had to take several weeks worth of diflucan( another problem with diabetics) for oral and esophageal candida. The ent that he is sending me to is at the University of Texas Medical Branch, and specializes in chronic sinusitis and also has taught the FESS technique. I have a brochure about the guy and did some research....and it looks like he is the best Houston and the surrounding area has to offer. I am glad that my own Ent was wise enough to send me to him. I have known this DR. since I was in my early 20's and was being treated for allergies. The sinus issues have been going on for years... Its just been steadily getting worse ie... headaces, constant post nasal drip and throat clearing, worsening of asthma and lately... I can't tolerate breathing in cool or cold air....shoots some major pain behind my eye? I think that may be the problem with the sphenoid? Anyway....I can't see him until the 3rd of march, but my doc is trying to get me in earlier..I haven't heard from him yet tho. thanks again for the replies and advise. I am really nervous about having this done.... but it would appear as tho it is much needed. Robin

Sounds like you're on the right track - I've read lots of articles about the treatment of chronic sinusitis that have come from UTMB so it seems like you'll be in good hands.

Good luck with everything - let us know what the doctor says.

Sounds like you're on the right track - I've read lots of articles about the treatment of chronic sinusitis that have come from UTMB so it seems like you'll be in good hands.

Good luck with everything - let us know what the doctor says.

I will post after the visit. Thanks again!
Robin

In most cases, sinus surgery is a temporary fix. Unless you remove the cause (almost always allergies) the problems re-occur at some point and you're back to where you began. Yes, you have some short term improvement, but the constant exposure to your allergens will more than likely cause most of the problems to re-occur. Anyone with serious sinus issues caused by allergies should at least explore the option of re-locating if at all feasible. My location is rated as one of the top 10 worst places for allergies.

Sounds like the ENT you're visiting next is one of the best. I'd ask him point blank what are the chances of your condition returning.

In most cases, sinus surgery is a temporary fix. Unless you remove the cause (almost always allergies) the problems re-occur at some point and you're back to where you began. Yes, you have some short term improvement, but the constant exposure to your allergens will more than likely cause most of the problems to re-occur. Anyone with serious sinus issues caused by allergies should at least explore the option of re-locating if at all feasible. My location is rated as one of the top 10 worst places for allergies.

Sounds like the ENT you're visiting next is one of the best. I'd ask him point blank what are the chances of your condition returning.
Thanks for all the replies! I am waiting on the surgery scheduler to call me.
I am trying to avoid missing more work, so I'm shooting for spring break... around March 15th or so. I talked to the ENT for a good while.... he was honest enough to say that he couldn't promise me that the problem wouldn't return, because he can't be certain exactly what we're dealing with. It could be fungal, bacterial or a mixture. The maxillary that is completely blocked is a hard call, the others show a bubbly content, which according to him is probably bacterial. The other maxillary has a large retention cyst? (don't really know what that is.) The concha bullosa, he said isn't really an issue...and he probably wouldnt even mess with it. It's a benign variation... he says? I feel pretty comfortable with this doc. The nurse at my PCP's office has had FESS done by him and she said he is a good, compationate, well trained doc. I trust her and my PCP. He is waiting on the insurance co. to approve an overnight stay due to my diabetes and COPD. My PCP sent the medical clearance form to them and stated on it that he would recommend the same thing.... just to monitor blood sugars and breathing. So, I think between the 2 of them, it should go through ok. As far as relocating....I live in Pasadena, tx... suburb of Houston, so...I think you could be right on that one....most polluted city in America :(, but, I have been here all my life with most of my family here...so I would have a really hard time moving. But the ENT did say he would like to do allergy testing on me afterwards.... just to see if anything shows that could be treated. Thanks again for all your replies! I will post again....hopefully with a surgery date and time...so everyone can keep me in their prayers. Robin