Hello, I just wanted to update this question by letting you know that I'm not expecting the answer in 24 hrs or so.. plz take some time and get back to me, no rush. I need help answering all of my questions in depth and precisely plz..

thanks !

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I'm seeking ENT medical board opinion please:

Hello Sir,

Background:

I’ve been suffering from sinus condition from many years (7 yrs plus). I had one sinus surgery done in Oct 2010. At that time, I was diagnosed with deviated nasal septum, had narrow passage on right nostril. Procedure performed: Bilateral Endoscopic Sinus Surgery with Septoplasty. my ENT cleaned mucus filled sinuses, widen the right side nostril passage. Within a year, I was having facial fain so I did another CT. I went to see another ENT, I was told that I’m having blockage in left frontal sinus (complete opacification) and that is because of the bone has grown and blocked the drainage – bone might have grown either during the healing process or because of scaring due to the surgery done in Oct 2010. Another opinion from other ENT suggested that bone can not grow there and it is not a bone. I’m confused !

Could you help answer all of my questions precisely and in depth please:

q.1 looking at the CT, do you believe that my blockage is caused by a bone? Is that a bone or just really hard mucus/ solidified mucus got built up over the time? If it is a bone then what should I do now? Can I leave / should I leave the blockage for the long time, I’m 35 yrs male. What are the long term effects? Can that spread any infection to eye or brain on a long run? I’ve attached word doc that contains CT images and Lab reports.

q.2 I’m having Constant mild or dull pain 24x7 on the bridge of the nose, surrounding both the eyes, mainly below both eyebrows, area of the nose that is between the eyes. See my picture attached, I’ve marked the areas of pain with arrows and circles. When symptoms are worse, pain/pressure goes mild to severe. I feel that dull pressure or pain on both the sides (not only left), my questions are: If I’m having only left frontal blocked what justifies my pain on right side too? why I feel dull pain on the areas I’ve shown in the picture? Why heaviness on centre of the nose or bridge of the nose? I know left maxillary is also little filled up with mucus per the latest scan Oct 2014, but still why I feel heaviness on the centre of the nose, surrounding right hand side eye, below right eyebrow too and bridge of the nose instead of just the left side of facial areas? Do my symptoms match with CT? FYI.. I also feel waking very tired every day in morning (even) when have 7 hrs of sleep Mon- Friday, work week.. when I raise the eyebrows up and down I can sense the heaviness.

q.3 what is the reason for fatigue? Why 7 hrs of sleep not enough for me and I feel tired, feel lack of ability to concentrate? Does my clinical condition based on CT supports this? Is my Blocked sinus responsible in anyway for fatigue - even indirectly?

q.4 my ENT has proposed this procedure to remove frontal blockage: Rev. F.e.s.s. + Mod. Endoscopic Lothrop + Landmarxs – to remove the bone, basically they suggest to drill the frontal sinuses bone, combine the drainage of right and left both the sinuses into one. My questions are: will that help resolve my facial pain areas shown in the picture? What could be the consequences of doing such surgery as ENT is suggesting removing large chunk of bone. I’m unsure what to do? What are the long term drawbacks that I should be aware of ? just because the fact that removing blockage is a good thing, will I be worse off in future by doing this / facing other problems unknown at this stage? what are the complaints and feedback - positive and negative both - of other patients who have had their frontal sinuses drilled? Is such type of surgery a common or a minor procedure, that I should not hesitate to consider doing that or are there serious consequences that I should be really mindful of?

q.5 I’m using sinus rinse kit from some time, what is the best way / best position to use it to allow the saline water to reach to the frontal sinuses or that can benefit specifically to my condition? Here is the YouTube link to give you some idea of the rinse kit with the pre-mix sachet that I’m using. https://www.youtube.com/watch?v=LW9mvVe7Mk4 they suggest to lean forward, tilt the head down in the sink and insert the tip but I think it only goes to the maxillary area, what about the frontal sinuses? For my specific condition for frontal blockage what is the right methodology to use rinse kit? I guess, because of the blockage, saline water is not going to clean up left frontal but still I want to know the best method that can give benefit for my condition.

q.6 Can I use rinse kit in this way or would it harm? Tilt the head completely upward, like watching towards the ceiling, insert the rinse bottle tip and pour the saline water into the each nostril one by one while holding the breath. While holding the breath, move head left and right side slowly, keep head in upward position for 3-5 sec, then tilt the head down, let the water out, whilst bending the head down, move head left and right to clear up the remaining water.

q.7 if I continue to use rinse kit, for let’s say 6 months daily, will it remove the blockage in frontal sinus? I haven’t used it daily basis for prolonged time as yet.

q.8 my latest CT is also showing some blockage in left maxillary, I’m using this rinse kit, will it remove the thickening with the periodical use over a long time, let’s say if I use daily for 3 months – will that all stuck mucus go away ? I guess that blockage in maxillary area is a sticky material like a paste.

Your help is very much appreciated..

Thank you !

Raj