Dr. Mehak Agarwal
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have had sinus infections for one year. Recently, I am experiencing a lot of congestion on the right side of my nose. I wake up with congestion on the right-side nose. I am wondering whether my septum has deviated to my right. The deviation is about 4 mm to my right side. My query is could I benefit from the straightening of my septum? Kindly help.
Hi,
Welcome to icliniq.com.
The deviation appears to be minimal, and your symptoms would not improve by addressing the deviation alone. We need to rule out allergies as a cause for recurrent sinus infections. Next, have you had any sinus surgery earlier? Kindly upload the entire CT (computed tomography) scan to have a clear assessment. Have you done allergy testing like comprehensive allergy profiling of the blood or a skin prick allergy test for ruling out allergies? Do revert and let us discuss the best way to manage your condition. Thanks.
Patient's Query
Hello doctor,
Thanks for the reply. Yes, I do have allergies. And I had a septoplasty two years ago. According to the radiologist, the deviation is about 3 to 4 mm right now. Before my surgery, the deviation was around 10 mm. My allergies are well-controlled as I take Xyzal and Dymista. Unfortunately, it seems I am unable to add the whole CT scan right now. But the slices I previously included are perhaps the most representative of my deviation. At the time of this CT Scan, it was determined that I had a sinus infection in the back of my nose around the sphenoid area. Hence the first slice, in particular, concerned me since it shows the sphenoid region clearly, and there was no space between my septum and the middle turbinate on my right. Now, I am taking Levaquin to control my infection. I am on the eighth day of a ten-day course. I have attached two more photos of my CT scan in case it might be helpful. Thanks.
Hi,
Welcome back to icliniq.com.
The CT scans are of the maxillary sinus region and the middle of the middle turbinate (attachments removed to protect the patient’s identity). There is some lack of space between the septum and the higher areas of the middle turbinate. It is partly due to the bony factor, and most of it is due to mucosal thickening over the turbinates, indicating the most likely reason to be allergies. None of the CT slices depict the sphenoid region. The CT images uploaded now show significant mucosal thickening and pus in the ethmoids on both sides. Probably, that is the reason you have been put on strong antibiotics. Meanwhile, in these cuts, the septum seems unremarkable and normal. In contrast, the mucosal thickening over the turbinates and sinus air cells is significant. You will be benefitted from a short course of oral steroids. I suggest you take a skin prick allergy test to precisely diagnose the cause of all the problems you have. The mucosal thickening is a result of the constant irritation that some aeroallergen is causing in you. The allergy test will detect the same. I strongly advise you to get the test done. Kindly revert to discuss further. Regards.
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Otolaryngology (E.N.T)
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