Endoscopic Sinus Surgery

[phllystyl]

So my doctor decided that this procedure might be of interest to me, and I was wondering if anyone here knew anything about the procedure beyond the basics...

here is my situation:

chronic multiple cases of sinusitis (atleast 2/ yr) which require antibiotics to resolve, has been occuring since I was in 10th grade (9 yrs ago). Have seen an allergist and had a screen, with no apparent positives. Have been taking allegra and flonase for the past 3 years - it does help considerably, I do get colds etc alot less, but I still get sinus infections 2+ times a yr.

Any thoughts?

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[doughboy]

Look into a procedure called chemical cauterization. It can be an alternative to the sinus surgery. However, I don't know how many ENT's actually do the procedure. It involves spraying certain solutions into the nasal passage which cause a chemical burn(painless) which will hopefully scar down and keep the mucosa from becoming edematous and inflamed. You have to have it done at certain time intervals which are then spaced out depending on how you do. I know some docs in Chicago but since you're not there, you might have to look into it where you are. Either way, I've seen many of the endoscopic sinus surgeries and they look fine. Most of the discomfort is from the nasal packing they put in after the surgery. Other than that I was surprised by how well people's faces heal up a week after the surgery.

 

[Skip Intro]

Just a question, phllystyl...

Are you by any chance allergic to aspirin and do you have a concurrent asthma? If so, you may have Samter's triad. I suffer from this and it's miserable (2 FESS procedures, mutiple inhalers, etc.). In addition to aspirin and NSAIDs, salicylates in foodstuff can trigger this as well. There are differing options if you do. For example, you could undergo aspirin desensitization or start a leukotriene inhibitor (montelukast, zafirlukast) and/or lipoxygenase inhibitor (zileuton). This syndrome is occassionally missed, even by the best of physicians.

If it's straight IgE/eosinophilic variety of inflammation with longstanding or repeated sinus infection, there is also anti-IgE monoclonal antibody called rhuMAb-E25 (made by Genentech). I'm not sure if it's been marketed yet, but it looks promising for allergic-type nasal and asthma.

Good luck with the FESS if you go for it. As I said, I've had two and they were both pretty miserable (the packing was the worst). Expect to be "OOC" for a couple days ("out of commission").

-Skip

 

[PainMan]

I used to get chronic sinus infections until the allergest told me to buy a new pillow and put a dust mite cover on it...It worked. I am allergic to dust mites....yuck.

 

[phllystyl]

Thanks everyone for the advice thus far.

No I am not, afaik, allergic to aspirin, and I do not have concurrent asthma with my sinusitis.

I am considering having an allergy rec-screen though... maybe this can be avoided.. Id much rather just take augmentin twice a year than have this operatiojn with sounds nasty, painful, and not terribly effective.