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francesc 01-22-2013 01:27 AM

Sinus surgery?
 
Hi all.
Im a 29 year old female and I have been recommended to undergo FESS and septoplasty. I am wondering if this seems reasonable based on the information below? Or should I get a second opinion? I would like my symptoms gone and am relieved to have finally had an ENT take me seriously but the surgery seems like a big deal. Thanks!
Frances.

My symptoms are frequent frontal headaches (between my eyebrows, and when they get bad involve pressure behind my eyes, probably at least once a fortnight im knocked out for at least a day if not more by one, and theres a constant 'awareness' of that region even when im not in heaps of pain) and get frequent sinus infections, at least 4 a year. My nose always feels blocked, I am constantly sniffing but if I blow my nose there isnt really much to blow out, and it kinda feels like the lining of my nose is dry and irritated. ANd i have postnasal drip and always get really bad coughs when ive been sick that can last for months. This is been for years, I had a CT and saw an ENT in 2008/9 who just said to use sinus rinses and saline spray and then a sterioidal spray if that doesnt work. I've tried the saline sprays and rinses. Ive tried rhinocort aqeuous but stopped after 2 weeks as made my nose so dry there was blood when I blew my nose. Maybe i haven't tried them all long enough but it hasnt really gotten better. Ibuprofen and paracetamol dont do much for the headaches.

An in-office endoscopy showed a deviated septum to the right (its usually my right eye where I feel the pressure during the headaches).

Recent CT report is as follows:
Nasal bony septum deviated to the right. Ostiomeatal complex is patent on both sides. Minor mucosal thickening involves floor of left maxillary sinus due to chronic sinus disease. There is no air fluid level. Remaining sinuses are clear. No evidence of acute sinusitis. Bones are intact. No soft tissue mass. Nasal passage is clear. Conclusion: Mild left maxillary chronic sinus disease.

Serenity0202 01-22-2013 06:23 AM

Re: Sinus surgery?
 
Hi,

I'm a 29 year old female too and I have virtually the same symptoms that you have. Except in my case I've had a chronic sinus infection for 3 months. Before that it was just reoccurring.

As far as I know, sinus surgery is a last resort where medication has failed. And with cases of breathing difficulty, it's quite necessary. I also have a deviated septum to the right as well as concha bullosa. For years medication did work for me but eventually it wasn't working anymore and I got sicker and sicker, with shorter gaps of time in between the infections.

If you say that the saline rinses/sprays etc aren't working then maybe you should consider it. Maybe also do some reading online about it. I believe a septoplasty (which is the procedure you would need to fix a deviated septum) is considered quite a minor procedure as far as surgery goes. According to my ENT it's not even "proper" sinus surgery as they don't go into the sinuses, he calls it "sinus passage" surgery.

If it would help you, I'm having a Septoplasty and Turbinate surgery next week Tuesday. I'll keep you updated about how it goes and where it helps my condition :)

rsierra1025 01-22-2013 09:04 AM

Re: Sinus surgery?
 
Hey, good luck with that. Just an FYI, for some people that deviated septum work can open a new set of issues. I always recommend looking at every possible alternative before that first go round under the knife. Rinse isn't working, too bad. You may look at the peroxide flushing, give it a try. You aren't out anything other than a couple of bucks for the peroxide but don't mix it strong. Try accupuncture/chiropractic and if you haven't been tested get checked for allergies. I still had issues with thick mucus after my last surgery so I started taking clariton, then Zirtec...no luck. They put me on a medicine that allergy/Asthma patients use and it's helped a lot. I know all of these suggestions seem a little crazy and a bit like grabbing at straws but my issue was scar tissue after my deviated septum surgery. I know some people don't have any problems after that procedure. Knowing what I do now, I wish I would have tried a few more alternative approaches before the knife. Also, you may ask about the balloon. It wasn't successful for me last year but as I mentioned I have scar tissue issues from multiple surguries before, for you it may work. Good luck.

gcsjr 01-22-2013 04:49 PM

Re: Sinus surgery?
 
Based on the CT scan results (mild left maxillary chronic sinus disease), there is NO WAY you should be considering surgery without a second opinion and a clear understanding of exactly what the surgeon is going to do and why it's necessary.

In the meantime, you should definitely be doing saline rinses with a sinus rinse bottle ow neti pot at least twice a day, and you should definitely be using Rhinocort daily (for more than 2 weeks).

Your best bet before surgery would be trying to get to the bottom of what's causing your sinus inflammation. It could be allergies (have you been tested), environmental irritants (chemicals, sprays, etc.) or even acid reflux (which can cause sinus inflammation and post-nasal drip).

I would STRONGLY recommend against peroxide rinses - they are very irritating and, while they might help if you have a bacterial infection, my ENT (who is very open minded and has even recommended some alternative treatments) told me I would be nuts to even try them.

Serenity0202 01-22-2013 08:50 PM

Re: Sinus surgery?
 
[QUOTE=gcsjr;5121420]I would STRONGLY recommend against peroxide rinses - they are very irritating and, while they might help if you have a bacterial infection, my ENT (who is very open minded and has even recommended some alternative treatments) told me I would be nuts to even try them.[/QUOTE]

gcsjr,

Thank you for your post about peroxide rinses, many people have suggested that I try it and you've just confirmed exactly what I think about them. They seem very risky to me.

francesc 01-24-2013 06:53 PM

Re: Sinus surgery?
 
Hi,
Im certainly not rushing into it, especially as the CT report didnt seem to show much asides from deviated septum and the mucosal thickening.
I guess I just wonder if its still worth getting the surgery, at least the septoplasty? I certainly feel as if I dont breathe properly, and when the ENT did an in office endoscope he couldnt go into my right nostril as far as he usually could because of the septum encroaching into my right sinuses. And I dont think its allergies, as i dont sneeze that much (unless ive been swimming in a pool) and dont have itchy eyes. I still will get allergy tests first just to eliminate it (do have a family history of allergies).

How long should I use rhinocort aqueous to really decide if its helping me? I stopped using it last time cos it made my nose so dry it bled.

Serenity0202 01-24-2013 08:56 PM

Re: Sinus surgery?
 
[QUOTE=francesc;5122548]Hi,
Im certainly not rushing into it, especially as the CT report didnt seem to show much asides from deviated septum and the mucosal thickening.
I guess I just wonder if its still worth getting the surgery, at least the septoplasty? I certainly feel as if I dont breathe properly, and when the ENT did an in office endoscope he couldnt go into my right nostril as far as he usually could because of the septum encroaching into my right sinuses. And I dont think its allergies, as i dont sneeze that much (unless ive been swimming in a pool) and dont have itchy eyes. I still will get allergy tests first just to eliminate it (do have a family history of allergies).

How long should I use rhinocort aqueous to really decide if its helping me? I stopped using it last time cos it made my nose so dry it bled.[/QUOTE]

I don't know, based on my experience I think a deviated septum can cause a lot of sinus problems. Maybe get a second opinion and try some other treatments, if you would feel more comfortable with that before deciding on a surgery. I have no idea what rhinocort aqueous is do I can't really comment on that other than to say that anything that drys your nose out so much it bleeds doesnt sound good to me but I'm not a doctor and that's just my opinion. Ask your doctor about it.

In my experience nasal sprays have been quite useless, for me at least. And you also run the risk of rebound congestion as they are not meant to be used long term. Three things that have really helped me are daily flushing with a neti pot and homemade saline solution (cooled boiled water, sea salt and bicarbonate of soda), a humidifer and steam therapy with inhalant oils. They certainly haven't cured my reoccuring or chronic infections. But have helped relieve symptoms. I believe a sinus rinse bottle is even better but havent been able to track one down yet.

Also, allergies don't necessarily mean that you will have a lot of sneezing and itchy eyes. I have allergic rhinitis and while I do sneeze and have itchy eyes occasionally, in my case, allergies are mostly a skin and congestion issue. I break out in hives constantly during allergy seaon and my skin itches so much that I end up scratching it open. Anti-histimines help. Best to see an allergist and be sure if you have a family histiory of it and to rule it out as a cause for your sinus issues.

gcsjr 01-25-2013 02:55 PM

Re: Sinus surgery?
 
[QUOTE]In my experience nasal sprays have been quite useless, for me at least. And you also run the risk of rebound congestion as they are not meant to be used long term[/QUOTE]
Just to clear up one mistake in this post - rebound congestion is only a risk with decongestant sprays that contain oxymetazalone (like Afrin). There is no risk of rebound congestion with Rhinocort, Flonase and other steroid nasal sprays (which are used to treat inflammation and rebound congestion from overuse of Afrin).

Rhinocort and other steroid nasal sprays are made specifically to be used long term and are very safe.

francesc 01-25-2013 02:58 PM

Re: Sinus surgery?
 
THanks! Thats what the doctors told me too, that its safe to use. Do you know how long I should take it before I conclude it hasnt helped? And is it ok to keep using it even if it made my nose so dry there was blood on my tissue when I blew my nose (so not a full on nose bleed)? Thats what happened after 2 weeks of use. The chemist told me to stop for a few days but then I just didnt get back into it cos I didnt wnat that to happen again.

gcsjr 01-25-2013 04:35 PM

Re: Sinus surgery?
 
You need to give it at least a month. If your nose is dry from it try sleeping with a humidifier in your bedroom, drink lots of water and try one of the many fine nasal moisturizing products - Nozoil, Nasogel, etc - to help with the dryness.

Rhinocort is water-based so it's one of the least-drying of the nasal steroid sprays. In the winter, when the air is extremely dry, even Rhinocort can cause some dryness.


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