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Medical Forum / Diseases and Disorders / Sinusitis / December 2006question for Murray
Hi. You said On 12/23/06 5:45 AM, in article 1166881541.101433.98040@a3g2000cwd.googlegroups.com, "judy.n" <judy.nudelman@gmail.com> wrote: > On the other hand, people can be > chronically, constantly, actively infected, and the CT can look pretty > normal. This doesn't happen with the CT scans. You can have a nasal infection and not show sinus disease, but CT scans are quite accurate. You can have a neuralgia or referred pain and call it sinusitis and the CT will be negative. MRI for sinuses are very misleading as they show positive with the slightest mucus. My question: then is it best to have a CT Scan when you are having problems or NOT having problems or does it matter. My doctor seems to prefer to order a Ct Scan next time I have a problem. Mel >Hi. You said >>>>>>>>>>>>>>>>>>>>>>> [quoted text clipped - 18 lines] > >Mel Mel, I just posted a reply to this post of Murray's. In essence, if I had gotten sinus surgery based on a CT scan diagnosis while I was still infected, I'd be sitting here today looking down the nose of an unnecessary surgery. IOW, it matters. Scan when you're as infection-free as possible. I'm glad I did. Rick On 12/23/06 4:02 PM, in article 5sjjh.890$nK1.91@newsfe06.lga, "MZB" <moo@noway.prudigy.net> wrote: > Hi. You said >>>>>>>>>>>> [quoted text clipped - 18 lines] > > Mel Since we have the instant CT scanner in the office, we do it at the patient's visit so that we can finish the diagnosis in a single visit and plan best therapy. There is no single answer whether do CT when sick or well. There are indications for not doing the CT i.e the MRI shows disease but the direct exam doesn't. No CT . Certainly if at the visit the pain etc is there for weeks, take it then since is is the best guide for Rx. In our office we need to know if pulsatile irrigation alone will do the trick or if no amount of therapy except surgery is best for the patient. In other words, patient has had symptoms for months, has been on meds for months, take the CT then. It is the best guide to therapy. It is best too because some patients will benefit by more abx, but you save the patient from unnecessary antibiotics when the CT is done and read at the visit . You've posted that a biofilm infection will not show on a CT. Why do you not consider a biofilm infection a sinus infection? Biofilms are implicated in chronic otitis media--yet they're still considered otitis media. Judy > On 12/23/06 4:02 PM, in article 5sjjh.890$nK1.91@newsfe06.lga, "MZB" > <moo@noway.prudigy.net> wrote: [quoted text clipped - 34 lines] > patients will benefit by more abx, but you save the patient from unnecessary > antibiotics when the CT is done and read at the visit . On 12/26/06 5:28 AM, in article 1167139682.829360.119570@h40g2000cwb.googlegroups.com, "judy.n" > You've posted that a biofilm infection will not show on a CT. Why do > you not consider a biofilm infection a sinus infection? Biofilms are [quoted text clipped - 26 lines] >>> >>> that's the point I am trying to make. Patient says I have a sinus infection but the CT was negative. The correct question he should ask is, Why do I have pain in my sinus area? So the CT is negative - cervical pain, neurologic, vacuum, migraine, psychosomatic or ?? For us the main value of the CT is to decide whether to continue on medications or save time and go to other treatments. I think the biggest value has been in giving us a means to reduce antibiotics. >> Since we have the instant CT scanner in the office, we do it at the >> patient's visit so that we can finish the diagnosis in a single visit and [quoted text clipped - 8 lines] >> patients will benefit by more abx, but you save the patient from unnecessary >> antibiotics when the CT is done and read at the visit .
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