Betty Edwards22 said:Hi there,
First, I should note that not all doctors practice identically—that is to say, they don't always opt for the same interventions at the same time—so my perspective might differ slightly, especially since Merkur follows a different rhinological school of thought than what you'd find at Vineyard.
So, the stance I generally advocate for is treating the clinical symptomatology—essentially, focusing on what the patient actually reports rather than just the CT scan findings.
I don't have specific data regarding the patency of that right cavity, but judging by the headaches described, I would be inclined toward a septal reconstruction; specifically, removing a spur that might be triggering trigeminal pain via contact with the ethmoid cells.
As for the CT scan itself, it isn't particularly problematic: osteomas are typically monitored, and a minimal mucosal reaction isn't really a sufficient reason to proceed with FESS.
In conclusion, one could resect the bullous antrum, which likely formed as a reaction to uneven volume within the cavities, leading to hypertrophy on one side.
S+FESS can be performed simultaneously, though that depends heavily on the surgeon's speed and skill—or rather, the available operating room time—and we do deal with those kinds of constraints here.
First off, thank you so much for the response; perhaps I am feeling a little less anxious now...
Of course, the moment I read the word "osteoma," I went into a total panic..
The CT shows normally pneumatized and clear maxillary, frontal, and sphenoid sinuses, along with normal osteomeatal complexes.. The biggest issue is my headaches—sharp pains that wake me up several times a night; I’m going absolutely crazy from them.. and this has been happening for years now.
Perhaps the wisest course of action is to address that deviation first, and then simply monitor the osteoma. It doesn't grow rapidly, does it..?
In your opinion, who is the best specialist in your area regarding septoplasty or rhinoplasty..? I mean, since I have to undergo surgery anyway, I might want to take the opportunity to fix the hump and the length of my nose while I'm at it.. Is that even possible at Vineyard?
Thank you so much..