chronic eosinophilic sinusitis

[42mom]

I was told I have this desease from a Wake Forest Dr. in N.C.   He said he could do surgery and it was about 4 hours long.  He also said that it would help me but not cure me.  Then I would have to do a bout of heavy predisone for a couple of months.  I started off at Thanksgiving with a cough and went to the Dr and was on antibiotics off and on for a month and finally went for a chest xray and they said I had walking pneumonia and asthma ( never had any trouble with this or sinusis before in my life) took cough syrups and nothing helped.  Then it all went to my nose about March and my Dr. got me in to see an ENT.  He done CT scans of my sinus and said I was a mess.  Had trouble breathing and severe coughing and drainage.  He put me back on steroids and anitbiotics.  Done another ct and it hadn't cleared up any and he told me to go to Wake Forest. Nothing helps but the steroids.( Dont want to keep taking but nothing else helps).  I am kind of leary abouth having the surgery but don't know what else to do.  Can somebody tell me if anything has helped them.

[Bhupinder Kaur, MD]

Hi,

This type of sinusitis is also known as chronic hyperplastic eaosinophilic sinusitis with nasal polyposis (CHES/NP) as it is usually associated with small polyps/swellings in the nose. It is the prominent accumulation of eosinophils that is the diagnostic feature of this condition. That eosinophils are a prominent source of certain inflammatory factors suggests that CHES/NP is a disease of unregulated inflammation in which eosinophils once present in the sinuses provide the growth factors necessary for their further recruitment, proliferation, activation, and survival.

For the treatment, simple measures like Nasal irrigation and flush promotes sinus cavity health.

In some studies, "daily hypertonic saline nasal irrigation improves sinus-related quality of life, decreases symptoms, and decreases medication use in patients with frequent sinusitis," and is "recommended as an effective adjunctive treatment of chronic sinonasal symptoms.

A relatively recent advance in the treatment of sinusitis is a type of surgery called FESS - functional endoscopic sinus surgery, whereby normal clearance from the sinuses is restored by removing the anatomical and pathological obstructive variations that predispose to sinusitis. However, Surgery should only be considered for those patients who do not experience sufficient relief from optimal medication.

Another recently developed treatment is balloon sinuplasty. This method, similar to balloon angioplasty used to "unclog" arteries of the heart, utilizes balloons in an attempt to expand the openings of the sinuses in a less invasive manner. Its final role in the treatment of sinus disease is still under debate but appears promising.

http://en.wikipedia.org/wiki/Sinusitis
http://cat.inist.fr/?aModele=afficheN&cpsidt=17457156

Please do keep me posted about the developments.

Warm Rgds,

[merciel]

I wondered if you had the surgery?

I have had the same symptoms and was treated with antibiotics and surgery by a local ENT. After I still had breathing troubles, constant coughing, and a new CT scan showed new sinus blockage, I was refered to a Wake Forest ENT. With the first appointment he diagnosed my condition as chronic eosinophilic sinusitis and prescribed 10mg predisone daily. I see him again next week and have another CT scan. I'm not too happy with the idea of surgery again.