sinusitis or ?

Hi Doctor starting three months ago exactly I got sick like I never did before with just huge gobs of clear mucus choking me and I couldn't sleep for nearly 4 days. After that I had a cough for nearly 2.5 months which just went away about a week ago. I've seen an ENT who did a full nasal endoscopy, sinus ct scan (normal), transnasal endoscopy (normal), double ph probe (normal), chest xray (normal), pulmonary function (normal), allergy test positive (very high) for dust mites.

Medications I'm on - Flovent 250 for asthma.

I still feel mucus in my throat some days and some post nasal drainage and pressure in my cheeks and face when bending over. However they tell me that I don't have a sinus infection because of the negative CT scan. I really believe I have/had a sinus infection. Can you please advise any other tests to get, can I still have a sinus infection despite the ct scan? Any advice would be greatly appreciated.

[Sumit Bhatti, MD]

Dear tasci,

Thank you for your query.

From the description of your symptoms, it appears that you have a problem with your sinuses. But since all the investigations are normal, medications should heal your sinuses. There is minimal role for surgery in such cases.

After a bad bout of cold and cough, it takes many months for the inflammation within the sinuses to subside. For your post nasal drip, you can take regular steam inhalation and saline nasal washes. You may need a course of nasal steroid spray as well. The improvement in ventilation of the sinuses will help them heal and return to normal. There is always a normal mucus blanket flowing through the sinuses. When this slows down or stagnates due to disease, you can feel it as a post nasal drip. Since you have been identified to have an allergy to dust mites, dust mite control measures will improve your condition and reduce the severity of your asthma.

In terms of additional investigations, you may consider an MRI  as it may pick up a Allergic Fungal Rhinosinusitis (AFRS) while a CT Scan may not easily detect it. You may also be a candidate for Balloon Sinuplasty to enlarge the openings of the affected sinuses.

Hope that this information helps and hope that you will get better soon.

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Regards.
Dr. Sumit Bhatti