Posted by: Vicky | 2011/10/10

Bad sinuses


Ever since I was a child, I''ve had ENT problems. I needed grommets 3 times before it actually worked and my nose, while not fully blocked, it always feels blocked and congested. I also have permanent post nasal drip.

I recently had an MRI scan for neurological purposes and it said this about my sinuses:
" fairly extensive mucosal thickening is noted - in particular in the ethmoid and frontal sinuses. Some mucosal thickening is seen in the maxillary and sphenoid sinuses as well" 
An ENT doctor came and prescribed Nasonex and said if it doesn''t do anything, I should go see him again. I''d just like to know, if I do go see him again, what treatment could he possibly suggest?

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Our expert says:
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Dear Vicky

A MRI scan is not the way to evaluate sinusses. Mucosal thickening implies that the lining of certain sinus cavities were inflammed, but this gives no indication as to the reason. That in itself does not mean that you need surgery, but the ENT was correct in prescribing the Nasonex, as this is a topical corticosteroid that will aim to reduce the level of inflammation (ie swelling) in the sinusses. The main thing is to see if you respond to conservative management, as this is always better than the surgical option. If you do not feel better, the ENT will have to order a CT scan, so that the true extent of the problem can be assessed. Treatment will be suggested after an examination of the nose. This may include certain types of antibiotics over an extended period of time, or even surgery if really necessary.
Your longterm problems with your nose tend to suggest a more chronic problem, so I do believe that the nasal spray will make a difference.


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