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Management of sinusitis with previous septoplasty and turbinectomy

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Hi i recently had a CT scan of my sinuses because I have had multiple sinus infections, postnasal drip all the time, have a chronic cough and facial pain to my cheeks and forehead. I had my reults printed out for me at the hospital but only see the doctor next week and I was wondering what treatment options she might offer me. I already had a rhino/ceptoptoplasty and had my terbinates burned over a year ago. My results stated that I have a small amount of mucousal thickening through my left maxillary sinus as well as a partial blockage in my left maxillary sinus, and a small osteoma in my left frontal sinus. I don't have the results in front of me so I can't remember everything the test said but that is the just of it. I also had allergy tests but nothing was posative
just a bit of my medical history if it helps: I have reflux, and chronic mild inflammation of my bowel. ADD, and anxiety. my current meds are nasonex spray twice daily(i have been on this for over 2 months), prevacid, and prozac 40mg per day.
on a side note I also have tmj problems, have difficulty sleeping(this has been going on forever), and I feel tired all the time. blood work I have had recently: CBCD normal electrolytes normal, no lupus anticoagulant present. THS was and ptt were just slightly like o.1. I also had the hospital print out a few older tests on from 2008 said my iron was low but no one ever informed me of this.

Category: Family Physician-GP

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Category: ENT Specialist
 19 Doctors Online


Thank you for your consultation at DoctorSpring. First of all, i am sorry for the exceptional delay in response.

I can understand your problem, and will try to help you the best possible

Let me explain the disease first ->
As per the history - You are suffering from
1. Chronic sinusitis
2. Left frontal osteoma
3. Gastroesophageal reflux disease (GERD)

Treatment ->
As per CT Scan report, you have limited sinus disease, so it can be treated with medication including
1. 3 week course of antibiotics (Amoxicillin + clavulanic acid ) 625 mg two times daily.
2. With continue nasal spray (nasonex spray twice daily for 3 to 6 months)
3. With antihistaminic medication including Tab.Levocetrizine 5 mg with monteleukast 10 mg once daily for 10 days
4. Steam inhalation

You don't need surgery for this limited disease.

Small frontal osteoma without any symptom doesn’t require any treatment, if it is increasing in size and causing swelling over face, then it can be shaved off for cosmetic purpose.

Continue treatment for reflux, with life style modification including
1. Weight loss can greatly reduce symptoms in obese people.
2. Avoidance of certain foods (such as caffeinated and/or carbonated drinks, chocolate, fatty foods, alcohol, and spicy foods) and stopping smoking can help to prevent reflux.
3. Eating meals at least one to two hours before lying down or going to bed and elevating the head of the bed a few inches may also help to prevent stomach contents flowing back up into the esophagus.

Summary of treatment:
1. 2 to 3 week course of antibiotics
2. With continue nasal spray
3. Tab.Levocetrizine 5 mg with monteleukast 10 mg once daily for 10 days
4. Steam inhalation
5. Reflux medication

Hope this helps. Please feel free to ask if you have any further queries.

Thank you.

Dr. Sunil Jalan

Dr. Sunil Jalan
Category: ENT Specialist
DAA (Diploma in asthma and allergy) : Christian Medical College, Vellore, 2012
D.N.B (ENT), 2011
Residency - M.S. (Master post graduate degree in otorhinolaryngology),  Christian Medical College, Vellore, 2009
D.L.O. (Diploma in otorhinolaryngology) - Christian Medical College, Vellore, 2007
Medical School - M.B.B.S, S.P. Medical college, Bikaner, 2004
Dr. Sunil Jalan and 4 other Medical Specialists are ready to help you

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