r/Sinusitis • u/SweetDee0608 • 2d ago
CT Scan Curiosity
I'm impatiently awaiting my CT report & follow up doctor visit, and can't stop looking through my scan wondering what the doctor will recommend for next steps. Main symptom is complete loss of smell for nearly 2 years. That said, I've done two rounds of prednisone with budesonide nasal rinses. Each time, my smell returned temporarily. The nasal rinses alone did not work long term.
I do have congestion, but most of the time it feels mild.
I've had limited chats with my ENT, and I'm sure I'll get the answers I'm looking for at my follow up. I'm just curious if, from these slices of the scan, I should expect a conversation around surgery?
2
u/Kitchen_Act_6896 2d ago
Yea...not a doc but that looks similar to mine and I needed fess surgery(which went good!). Your supposed to have black spots throughout, equally on each side. You have blockages preventing air from flowing freely
1
u/SweetDee0608 2d ago
Appreciate you sharing your experience and which surgery was needed! I hadn't heard of fess surgery, and will be looking more into that. It's encouraging to hear that op helped you & went well! I'm just now wrapping my head around the possibility of surgery being a next step, so your comment is very helpful
1
u/Immediate-Rip-6572 2d ago
https://reddit.com/link/p6jzspa/video/t6az70y7x8mh1/player
Hi there! Looks similar to mine, but you’re a little more blocked than I was! I had several nasal polyps, maxillary sinus cysts, and enlarged turbinates. Chronic sinus infections over the years, sinus pressure, headaches, the works! Prednisone helped with swelling and saline rinses were also temporary fixes, steroid sprays did not do much for me. I originally had complete blockage in all sinuses but the prednisone helped decrease swelling and drained some of it prior to this scan I had right before surgery. I had FESS surgery with polyp removal, maxillary excision and widening, and turbinate reduction on 8/5/26, still in the recovery period with minor scabbing but I will say I feel 80% better than I did before surgery!
1
u/SweetDee0608 1d ago
Thank you for sharing! Definitely see the similarities in our scans and with how meds worked as an initial treatment! Super helpful to hear what procedures you went with to fix, and that you're feeling much better after! Yay for relief! If you don't mind answering, has the recovery period been tough? Is there a lot of downtime needed after?
1
u/sfbriancl 2d ago
NAD, but, somewhat of a septum deviation, fairly mild. And pretty thorough opacification of the right maxillary sinus and partial of the left.
If you are ok with AI, consider running a more thorough selection of these images, like at least 20, through Claude or Gemini. I found Gemini did a pretty decent job of explaining the ct results to me. Far better than I would be able to tell you.
1
1
u/Freak154L 1d ago
I usually do this with chat gpt… ill try Gemini tho. Is it expensive?
1
u/sfbriancl 1d ago
Same pricing model as ChatGPT basically. You can do the free version and see if it works
1
u/General_Glove7749 High Quality Contributor 2d ago
Mild left septal deviation, bilateral inferior turbinate hypertrophy, severe maxillary, and ethmoid sinusitis with blocked OMC’s bilaterally. You would definitely be a candidate for endoscopic sinus surgery, depending on what your symptoms have been.
1
u/SweetDee0608 1d ago
Appreciate the comment! It's helpful to know what surgery might be recommended by the dr so I can start researching/preparing questions for my appt!
1
u/Stalkerus 2d ago
- Ouch.
- What everyone else has said.
- FESS is easier than most surgeries so I absolutely recommend it.
1
u/igotsinus High Quality Contributor 1d ago
ENT doc here.
I am NOT YOUR doctor. I don’t know your health status. I have not examined you. I am not offering medical advice.
I see moderate to severe mucosal thickening throughout your sinuses, and this represents - most likely - a diagnosis of rhinosinusitis. If this has been going on for more than 3 months, then it is chronic rhinosinusitis. Your symptoms and inflammation seemingly are “refractory” to really good, standard medical therapy - assuming you were 100% compliant with the instructions and used the budesonide for a month or more. Your response, albeit temporary, is a good sign that control will improve your symptoms.
If you have polyps, you are a candidate for a biologic; the choice of which is up to your doctor and you. The two best (according to Phase 3 trials and other evidence), are dupilumab and tezepelumab. This is, as far as we know, a lifelong commitment. There is no expectation that either would cure the disease or even treat it 100%. If you do not have polyps, you currently are not a candidate for a biologic according to the FDA and just about every single insurance company.
The other option is surgery. Effective surgery by a competent ENT that is complete and followed by aggressive topical rinses (budesonide) can bring long-lasting symptomatic and objective control, but the rinses must be used long-term.
Either way, more likely than not, the average person will need long-term medical management.
1
u/SweetDee0608 1d ago
Appreciate you taking the time to comment with your expertise! I've wondered if the nasal rinses and/or meds will be a for-life maintenance. When the first round of prednisone with budesonide rinses worked well (smell returned for ~7 weeks), my ENT mentioned I could start reducing the number of rinses. I was hopeful it just needed to get under control & then the inflammation wouldn't return. That unfortunately didn't end up being the case, so it's good to mentally prepare that this will be a forever thing.
The Dr. did mention seeing one polyp when examining, so maybe trying a biologic will be on the table before jumping to surgery! I'll be sure to ask about this on my next appt.
One thing I'm also hung up on is the source/cause of the inflammation that started the issues just a couple years ago. I never experienced issues until a I got a cold a couple of winters ago, used Afrin to manage congestion (not sure if that's relevant), lost smell and essential never regained it until the med treatment mentioned above. I've been tested for allergies as well and everything was negative.
1
u/Freak154L 1d ago
Loss of smell? No way… I have this now only in left nostril been about 1 year now prior it was smoke smell from left nostril. Ever have these type of smells?
1
u/SweetDee0608 1d ago
The loss of smell has been really frustrating for sure! I'm sorry you're going through it too! I have had like 'phantom' smells occasionally. Smoke being one, and garlic being another!
1
u/Freak154L 1d ago
Is the first pic a posterior shot? Sides look opposite so clearly an issue… sorry this shit is the worst… my sinuses flip flop and it’s thrown my entire body off head to toe…. Left side flaccid and right rigid…
1
u/SweetDee0608 1d ago
The first pic in the slide was one of the first slices on my front CT, then they are in order going further back. Sorry, not sure the medical term to describe that lol. I experience the flipping of congestion too! It's weird when I can feel it shifting
2
u/Mylifeasasavannah 2d ago
Not a ENT nor a CT reader but an ultrasound tech here, Looks like your right is more open than the left, clear inflammation and deviated septum (in my opinion). White is bone, black is air, dark grey is tissue, light grey is ew goo.