comments on prednisone and surgury

[Guest guest]

Prednisone is useful until its risks or side effects outweigh its benefits.For

me it was the

ocular complications namely C.S.C.R. (central serous choroid

retinopathy).Specifically it was

the central vision in my right eye being severely compromised. Steroid necrosis

of bone is

but another risk factor and there are many others.Also once the chronic changes

of Samter's

occur the benefit from taking oral steroids diminish. Regarding

functional endoscopic

surgery.I believe mostly the benefits outweigh the risks The surgury isn't done

unless there

are clear justifyable surgical goals..I had orbital cellulitis involving my left

eye on 2

occasions.Surgery was necessary to open up the frontal sinus as it was blocked

by bone and

could not drain.After the surgury no more orbital cellulitis as of yet (about 7

years)This was

my 3rd surgury where I was put out.At this point my sinuses are narrowing due to

calcifying

bone and thickened mucosa .My ENT will not do surgery at this point as my

sinuses appear

patent and there is drainage.NOW TO ME THE NAME A.E.R.D. OR ASPIRIN EXACERBATED

RESPIRATORY DISEASE IS MORE APPROPRIATE.I HEAR LITTLE TALK ABOUT THE AIRWAY

REMODELING THAT OCCURS WITH THIS DISEASE.Asthma will remodel the lungs and the

chronic sinusitis will remodel the sinuses.I have a mucocele that appears in the

ct scan near

an orbit as well. I'm told the calcification that occurs is from repeated

infections.To me the

surgery is essential.Sure there can be complications ie empty nose syndrome CSF

leaks,possible orbit or brain perforation etc. It's necessary to seek out the

most qualified ent

in your area.There is no cure for AERD in my lifetime. All we can hope for is to

slow the

disease process and diminish the symptoms and we read and try everything that

helps.

[Guest guest]

>

> Asthma will remodel the lungs and the

> chronic sinusitis will remodel the sinuses.

Right, Samter's remodels the nasal/sinus mucosa, making it more fibrous

and diminishing ciliary clearance. But there is a (remote but real)

possibility that this is partially reversible, at least in areas that

have not fibred too much.

>I have a mucocele that appears in the ct scan near

> an orbit as well. I'm told the calcification that occurs is from

repeated infections.

There are pus-filled mucoceles, fungal mucoceles, and also inflammatory

calcifications resulting from local injury ; inflammatory calcifications

are small and look vaguely rectangular. Fungal calcifications tend to be

round and at the center of a fungal ball, but the CT sometimes needs to

zoom on them to assess their shape properly. The color of nasal

discharge can give an indication too.

> There is no cure for AERD in my lifetime. All we can hope for is to

slow the

> disease process and diminish the symptoms and we read and try

everything that helps.

I would tend to be a little more optimistic, given the pace of current

research, and I am pretty sure we will see at least a far better

understanding of Samter's in the years to come, that will ultimately

lead to clinical improvements. But for the time being, slowing the

disease is the best we can achieve. Hopefully, the day will come when we

can freeze it to slow-motion.