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Question about surgery/frontal sinus risk

Wanted to run some basic questions by someone else, since the ENT specialist I'm seeing isn't very helpful. I've been dealing w/ a sinus infection for a few months and antibiotics didn't get rid of it. So he ordered a CT scan, and told me today that I need surgery. He didn't show me the scan or give me a report, but said one sinus on my cheek is completely blocked, one on my forehead has some blockage, and I think 1-2 others have some blockage too. I should say: My symptoms don't seem that bad. Noticeable (mainly post-nasal drip/mucus in throat), but not awful. Only other symptom is sort of tenderness/achy feeling on side of my neck (a new symptom, not sure if it's related).

I don't like the idea of surgery, but what I'm worried about is when he told me if I did nothing the infection could theoretically spread to my brain. He said this was very unlikely and downplayed the possibility, but wouldn't elaborate -- and now that I look online, I get the impression it's a serious possibility with the forehead (frontal) sinus issue. Now I'm paralyzed with fear. Am I going to suddenly get meningitis or a brain infection because of this? Should I be in the emergency room treating this? If so, why should I wait a month for surgery, which is what he's saying the wait it? Or is there some homepathic way I could treat this, with a Neti pot or whatever?

I'd still like to avoid surgery. But I'm also scared now that my life is in danger.
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1766450 tn?1314054716
Dear questions55,

Thanks for writing in.

First of all, I would like to reassure you that the things what you have described does not seem to be very serious.

There are two types of sinusitis (i) Acute sinusitis (with a short duration of symptoms) and (ii) Chronic sinusitis (long-standing symptoms)

Bacterial sinusitis is almost harmless, a course of antibiotics generally eliminate further problems. In rare cases, however, sinusitis can be very serious. Bacterial infections from the sinuses can spread through natural dehiscences and weakness in the bony barriers. In long standing infections, the surrounding bone undergoes pressure necrosis due to constant presence of fluid, while in acute stage massive osteolysis (bony destruction) is commonly seen.

The features of acute sinusitis are fever, headache (pressure or pain behind the eyes, toothache, or facial tenderness), nasal congestion, nasal discharge, bad breath or loss of smell, cough, sore throat and postnasal drip. Whereas in chronic sinusitis the features are almost similar but not associated with fever or any life threatening symptoms.

With your description, there does not seem to be any signs of any complications or acute episode, it could be more of chronic sinusitis involving the left maxillary sinus and the frontal sinus without much of debilitating symptoms.

The neck pain could be a referred pain from the throat, due to post nasal drip causing inflammation of the posterior pharyngeal wall.

I do not think that you need to rush to the emergency and get the medications. I feel, you need to discuss with your doctor and start on medications for opening up of the sinuses.

The medications include steroid nasal spray (such as fluticasone or momentasone) a mucolytic (such as bromhexine or ambroxol) and probably a course of antibiotics if your post nasal discharge is either yellow or green. Apart from this, you need to do steam inhalation 3-4 times a day, drink plenty of warm water (to rehydrate the nasal and throat mucosa); avoid chilled beverages, excessive coffee/smoking if any. Neti pot can also be tried to decongest the sinus openings.

Surgery is planned only after giving the necessary medications for at least a period of 6 months (unless there are complications involved) and it has failed to resolve the symptoms or the disease.

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

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Best Regards,
Dr. Naveen Kumar
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