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Medical Forum / Diseases and Disorders / Sinusitis / January 2006Getting ready for surgery questions
My sinus surgery with Hwang in Stanford is scheduled for Feb 11 and had a few questions. He will be doing a septoplasty, ethymoidectomy, haller cell removal, cyst removal, enlargement of the maxillary otia complex (sorry for lack of technical terms, I haven't gotten the report yet). 1. Do you recommend image guided surgery? He does it, but didn't mention it during my appt. 2. Has anyone taken Ketek? It's a ketaloid, a newer class of antibiotics that has greater effectiveness than macolides against resistent strep pneumonia, which I think has been my problem. The only antibiotics that have worked for me are cipro and avelox and both being floroquinolones are hard on my system. Levaquin worked once, but not the second time. Biaxin, amoxicillin, augmentim, and bactrim do little. Anyone see a pattern here? Even though I'm having surgery, I am likely to have another infection before that time. In other words, no antibiotic is killing it off entirely, no matter how long I take it, so it comes back within a week. 3. Has anyone had success with sampling the mucous for the actual bacteria? Whenever I ask my doctors about this they say it's not accurate. Thanks! >My sinus surgery with Hwang in Stanford is scheduled for Feb 11 and had >a few questions. He will be doing a septoplasty, ethymoidectomy, haller [quoted text clipped - 3 lines] >1. Do you recommend image guided surgery? He does it, but didn't >mention it during my appt. Go with his recommendation as to which way he prefers. It's a great aid in certain cases and for inexperienced surgeons, but you lose resolution with it, relative to the visual approach, so some very experienced surgeons prefer not to use it in many cases. They simply to not need it and it gets in their way of doing a perfect job. I think you can assume that the surgeon you mentioned will not get lost navigating the anatomy. ..... >3. Has anyone had success with sampling the mucous for the actual >bacteria? Whenever I ask my doctors about this they say it's not >accurate. Right that is what many have told me - that it is occasionally helpful; but in general is not. Dr. Kennedy did do it for me (at his own in initiative) a couple of times and mentioned that such and such a bacterium that was present was sensitive to such and such an antibiotic. So sure, you could suggest that...... Good points about image guided surgery. That explains perhaps why it seems more recommended for delicate areas close to the brain like the frontals. My case is relatively simple. >Good points about image guided surgery. That explains perhaps why it >seems more recommended for delicate areas close to the brain like the >frontals. My case is relatively simple. Perhaps but again, it gives less resolution to a very skilled surgeon than doing it by eye. Close tot he brain, you might want that fine resolution.... I just had image guided surgery on the 19th. Fortunately I was asleep so I cannot say much about it other than it was much easier than the first surgery with the septoplasty. I was all socked in on all 4 front sinus cavaties. My doctor says I will be back. Actually tomorrow I will be back for a checkup. I know that both surgeries I had I was about at the end of my endurance for the effects of this. My problem seems to be with mold and fungus so they haven't done any sort of samples for the bugs. I wish you all the luck in the world. My only advice is to make certain that your doctor has done lots of these. Bob >>Good points about image guided surgery. That explains perhaps why it >>seems more recommended for delicate areas close to the brain like the [quoted text clipped - 4 lines] > > Close tot he brain, you might want that fine resolution.... > My sinus surgery with Hwang in Stanford is scheduled for Feb 11 and had > a few questions. He will be doing a septoplasty, ethymoidectomy, haller [quoted text clipped - 12 lines] > but not the second time. Biaxin, amoxicillin, augmentim, and bactrim > do little. Anyone see a pattern here? Sure. In my case, my sinuses were so blocked that drainage was impossible. In fact, my left nostril was so blocked that my ENT was unable to even get his endoscope up there. Without drainage, the sinuses can't heal no matter how many antibiotics you take. All antibiotics had virtually stopped working on me. After surgery, the sinuses started to clear. You may get a much better response to antibiotics after the surgery. > 3. Has anyone had success with sampling the mucous for the actual > bacteria? Whenever I ask my doctors about this they say it's not > accurate. I had it done, but it was hard to tell the difference between a real infecting pathogen and a contaminant. Just taking a bath is going to introduce all kinds of bacteria into your nose from the bathwater.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > Has anyone taken Ketek? It's a ketaloid, a newer class of > antibiotics that has greater effectiveness than macolides against > resistent strep pneumonia, which I think has been my problem. Ketek can cause liver failure. <http://www.fda.gov/cder/drug/advisory/telithromycin.htm>
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