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Medical Forum / Diseases and Disorders / Sinusitis / April 2005Turbinates
Friends: I have had sinus problems for number of years, becoming chronic the last few. I am considering my options. I just had a CT scan done, as ordered by my ENT. It was released to me, so I went and read it (sinuses.com has a virtual tutorial on reading sinus CT scans). I'm not an expert, but it was obvious that my right turbinate (left on film) was much bigger than my left - maybe two or three times the size. The other aspects, such as the ostium, were more difficult to discern and I couldn't tell if they were healthy/unhealthy, normal/abnormal, etc. Then I remembered I had a CT scan 3 years ago and thought it would be interesting to compare the two. Would it be the same, worse, if so how much? So I get the CT (quickly, within two days) releaed to me and take a look. An employee of mine looked with me so there was no mistake [not only does the film indicate R and L, we looked at numerous landmarks, such as my septum which is a little crooked, to make absolutely sure]: On the original film it was my OTHER side (both turbinates, but especially the inferior) that was enlarged! These were dramatic differences, one is large then small, the other is tiny then huge. Now if turbinates are that flexible (sorry for the analogy, but it seems they are like erectile tissue, and we know how that tissue can vary in size)then what if we shrink a turbinate with surgery and it then decides to, shall we say, lose it's erect state and shrink. Wouldn't it be too small then? Sorry for the analogy again but isn't it like seeing an erect penis and operating on it to shrink it? Also, if they vary that much, how do we know that the CT scan reflects an on-going condition on not just a turninate that is swollen that day (or that hour!) I don't know how much of a problem my turbinates are, but I feel a lot better after using Afrin, especially if I then irrigate. But what to make of two schitzophrenic CT scans? Also, I am getting gentamicin delivered tommorow to irrate with. Any good stories with this. Does it give you at least a temporary period of feeling great, or does it just make you feel less bad? Thanks, Joe Well the turbinates certainly swell alternately on each side on a cycle of about every 6 hours. I imagine that is what you were seeing. Now, I do not know whether they are supposed to administer a spray prior to a CT scan that is supposed to cause them to go down for the CT scan. Dr. Grossan would know that. As to Afrin, it will cause addiction if used for more than a few days so I would regard it as just too dangerous for use. Steroid sprays are much safer (but less efective in the short term) and can be used long term. I doubt that the turbinates are the whole story. They tend to get inflamed due to the same allergies/irritants that affect the sinuses, so they are good markers, but I doubt that they alone cause sinusitis in general No, I doubt they are the whole story either. However they might be an essential link in the problem, without which I wouldn't have one. My main concern is this: Sinus diagnosis and treatment is a delicate and tricky business. I am sure members here have gotten conflicting diagnoses. I had no idea I could recieve 2 CT scans of my sinuses that differed so much. I just makes you wonder if one is enough, considering that thousands are treated, especially surgically, often in large part on one's CT scan. I want anyone who may operate on me in the future, if that is necessary, to see both CT scans. Seeing the two CT scans, does affect my view on surgery. Now I was planning to stay away from messing with my turbinates, and stick with the unctionate process removal and/or septoplaty if it came to that, but I didn't completely rule out turbinate reduction. Anyone thinking of getting their turbinates reduced may want to get consider my experience when they see their CT scans. Thanks for response Don. >No, I doubt they are the whole story either. However they might be an >essential link in the problem, without which I wouldn't have one. I doubt it personally. The real underlying problem is usually allergies or senitivities to irritants. Unless and until that one is addressed by scrupulous avoidance and elimination of allergens and irritants, along with lots of rest in some cases, to some extent most solutions mainly buy time or help relieve symptoms. I've had my tubinates reduced, and that is fine as far as it goes, but I can tell you that my sinuses go all to hell for up to days if I even have a few hours of exposure to an environment where there are some smokers. And that is regardlesss of the state of my turbinates at the time. They do tend to swell too, mostly afterward, for again up to days. Yes, smoke is poison gas, period. I follow what you are saying regarding turbinates. I am beginning to think Dr. Grossan is accurate regarding the cilia being the primary factor. Smoke and irritants seem to slow them. It's a plausible theory, anyhow. If the cilia are slowed, mucus can get thicker and gather bacteria instead of sweeping the bad stuff out. Like stagnant water, it gets funky very fast. Blocked ostia can cause problems too, but mine seems more the allergy type, described above. I have bad allergies and get shots, which help. But I do wonder if the allergies swell the turbinates which then may block up the ostium or other areas. Which leads me to this question: How do you know that the smoking messes up you sinuses "regardless of the state" of your turbinates? How do you know they aren't swollen from the smoke and perhaps blocking the ostium or whatnot? Do you associate swollen turbinates with not being able to breathe through your nose? If not, how else would you know they are swollen? Joe If I get any new product I have problems with them. Now if I get a new rug I spray them with Febreeze and keep an open window or close the door to that room. I had to get rid of that Damp Rid last year. We had put it down in the basement but some of the odor came up through the vents to our first floor. I had such a headache for days and felt ill. I told Hubby to remove it and my headache went away. shirley >How do you know that the smoking messes up you sinuses "regardless of the >state" of your turbinates? How do you know they aren't swollen from the >smoke and perhaps blocking the ostium or whatnot? Lots of rotten drainage. >Do you associate >swollen turbinates with not being able to breathe through your nose? Sure I can tell the state of my turbinates by how wide open my nose is. When they are really swollen I can barely breathe through my nose. >not, how else would you know they are swollen? > >Joe On 4/28/05 7:43 AM, in article h4t171t2gkftfhs73k8g3mno4v34h3fdst@4ax.com, > Now, I do not know whether they are supposed to administer a spray prior to a > CT scan that is supposed to cause them to go down for the CT scan. Dr. > Grossan would know that. No, you don't want a spray or to irrigate before the CT scan. Turbinates can completely block on Monday, be wide open Tuesday, block completely on the right side Wednesday, then only block the left side Thursday. This in physiologic. Does a stuffy nose always mean enlarged turbinates, or can there be another cause? Can a swollen turbinate block the ostium area, but still not interfere, or not interfere significantly, with breathing? Thanks for all the valuable input.
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