total opacification of Maxillary,ethmoidal sinuses

[Guest guest]

My most recent CT scan showed the near total opacification of

maxillary and ethmoidal ,and partial opacification of sphenoid

sinuses.The medial walls of the maxillary sinuses are poorly

defined.Also mucous opacified soft tissue structure medial to right

orbit measuring 1.1 cm. I have many headaches

and sinus infections. I have had Samter's since the early 1980's and

at least 5 separate sinus surgeries.I take Singulair, a baby

asa,Rhinocort aqua,Symbicort daily and irrigate daily with 2X ringer's

saline at body temp.(sometimes with xylitol or 1% baby shampoo).Have

had orbital cellulitis of left eye 2x and the last surgury involved

opening up frontal sinuses as they could not drain as blocked by

bone.This opacification pattern does not seem prevalent in this

group.I believe that some of what I have seems consistent with

allergic fungal sinusitis(the ct appearance).Want to get surgical

treatment for this but several ent's here are reluctant to treat.If

the sinuses are full of debris then shouldn't they be scraped ,mucin

removed and perhaps a postsurgical course of corticosteroids or

topical amphoterecin B.From what I've seen in the literature the above

treatment would make sense.Anybody out there have this experience or

any advice.I realize that allergic fungal sinusitis is a newer concept

but with so much going on structurally shouldn't treatment be done?I

live in Ontario where medicine is government run(so it would seem any

new treatments would be very slow to be approved,numbers of procedures

limited by the treating ent surgeon,waiting lines ie any measures to

keep costs down).Would reallly like to here from someone who has been

through this. I believe allergists and ent's should be working as a

group treating patients like us.Sincerely Wayne

Allergic fungal sinusitis:CT Findings,Radiology 1998;207:417-422