Mild chronic pansinusitis? - Sinus Problems Message Board

speak21 · 01-13-2009, 07:47 AM

I recently saw a copy of my sinus CT report, in which the radiologist's conclusion was 'mild chronic pansinusitis'. Everything I have read about chronic sinusitis indicates that treatment is a long course of antibiotics, which I would REALLY like to avoid. Since the report indicates that the disease is 'mild', does it really need treatment with antiobiotics, or could it be left alone? Are there any risks of not treating? I don't have any colored nasal discharge, though I do have a lot of clear drainage, so no obvious signs of bacterial infection.

Howie2 · 01-13-2009, 01:00 PM

I would like to know this as well. Mine is more moderate than mild. My doctor said sometimes the scans seem worst than they look. I was on 2 different antibiotics for 8 weeks. I have had congestion and fatigue since November. I saw the ENT 2 weeks ago and he said it looked better mostly white discharge. He told me to continue with Nasonex, Steam and the Netipot and no new script for antibiotics. I feel ok still a little fatigued and congested with some yellow. Mostly yellow when I do the Netipot..Blood in the AM. Maybe this means it is draining

Is it me or these infections take forever. This is my first...

gcsjr · 01-14-2009, 04:31 AM

Quote:

the radiologist's conclusion was 'mild chronic pansinusitis'.

That basically means that you have minor inflammation throughout your paranasal sinuses.

Chronic sinusitis typically doesn't require treatment with antibiotics (acute sinusitis does) but it can make you more susceptible to sinus infections because the inflammation can keep your sinuses from draining correctly.

Typically, instead of antibiotics, the doctor will encourage you to use a SinusRinse bottle or neti pot to help keep your sinuses draining correctly, and may prescribe a steroid nasal spray to help manage the inflammation.

Typically, the bigger challenge is figuring out what's causing the inflammation - allergies, environmental irritants, etc. - so you can keep it from progressing.

Howie2 · 01-14-2009, 06:23 AM

That is exactly what my doctor did. He had me on 2 antibiotics for 2 months with a 1 week of prednisone. He thought that the infection was under control. He then prescribed Asstelin 2 puffs day and night, Neti pot 2 times a day with Neil Med and Steam a few times a day. Problem is sometimes it is hard to tell if the infection is totally gone in the winter...

speak21 · 01-14-2009, 07:06 AM

Thank you! That is very helpful. I had an appt with the ENT yesterday, as I am still having some symptoms (some feeling of congestion, lots of PND, clogged ear). He said he saw a lot of inflammation, but not much sign of infection, so he prescribed a short course of oral steroids (6 days) and a nasal steroid spray.
Is it common to have the oral steroids without antibiotics? I was a little concerned about the possibility that there is some infection remaining, which the corticosteroids could worsen, but I tend to have a bad GI reaction to antibiotics, and would prefer to avoid them unless absolutely necessary.

Guess I just have to wait and see what happens.

As to the nasal irrigation, I have been doing that 2x per day for the last couple of weeks (first neti pot, then a pulsating nasal irrigation machine-SinuPulse), and I intend to keep that up. ENT thinks that most of my problems are due to structural abnormalities, but is reluctant to do surgery unless sinus issues start to have a strong negative impact on my life (currently they are more of an annoyance).