The CT scan is the most reliable tool they have for imaging the sinuses
(which are just empty spaces inside the skull).  But even a CT scan
isn't perfect.  It seems to have about a 5-10% rate of false negatives;
that is, 5-10% of the time, it fails to detect the sinus disease.  This
cannot be entirely due to misinterpretation by the ENT or radiologist;
usually several of them agree on what the CT scan shows.  It has more to
do with the fact that the resolution is no better than about 4 millimeters.

With appologies to Doc Grossian and other good ENTs who still have
live cognative faculties:

By having them "practice" on me and mine, and seeing what they have
done to my friends and
aquintances.

By having two positive hospital lab tests for fungus but being told
that it was "irrevelent".
(However when I was prescribed Sproanox, I got the first uninterupted
nights sleep in years.)

By realizing that they do not use the tests or the knowledge available
at the waste water plant to detect 99% of the microbial life there
and reading lines "but we can culture only about 650 species but we
can culture the medically important bacteria".
Thus what do negative cultures mean, that you sinuses are sterile even
though you are running green pus, or that what is growing there
does not grow under the standard culture conditions.
They consider absence of evidence with evidence of health, when they
intentionally do not look at most of the evidence.
Yeah, like if you could only see one car out of 100, how safe would it
be to cross the street?
If the you could use thermal goggles to see all the cars, how
reasonable would it be to refuse to use them?

By having samples from me that show a classical biofilm and having
"them" refuse to consider
that possibility, or order their own sample prepared without $100,000
accompanying grant money.
Getting the ENTs to do the research has been like pulling eye teeth.

And friend, I was right.  Go look up biofilm sinusitis in pubmed,

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed

Read Lusk's and Sanclement and Sanderson's papers,
(and realize that it is pretty easy doing a freeze fracture sample
to have the film to flake off during sample prep if you they are not
careful. So some positives are lost.)
and then take them to your ENT.
Odds on he will not even know what you are talking about.
No Halluaha Course, No "JOY at last we know what is going on."
No flurry of grant applications to do further research.
JUST THUD!!!!!!
"now can we get back to cutting your turbinates out"?
(Not just closed minded, but linked to a group mind sealed in a vault
somewhere.)

(((But mention Hultgren's work to a uroligest and he will immediately
know who and what you are talking about. But then uroligests don't
cut parts of kidneys out too often. )))

By looking into it and finding out how mutable diagnostic criteria
have been and how slipshod the studies.
I challange you to find published radiological studies with a general
population control group.
By trying to find general population strudies of deviated septum and
it's value as a predictor of sinus disease, and finding that if the
work
was ever done, it was not published, but to the extent it has been
reported, no corrolation was shown.

By witnessing the childlike way that ENTs treat the oxygen exchange/
flow control structures in one's nose as if they are
"obstructions".  The  polyp is usually the obstruction, and the polyp
is not an "overgrowth of the lining of the sinuses" it is a  biofilm.
Drop some live dead stain on one and LOOK at it.  A biofilm can be a
quarter inch thick, generous airways do not make you immune
to sinusitis. ENTs should not be allowed near a knife until they talk
to some fluid flow engineers.

Medicine is an observational science..
When a part of medicine starts severely limiting it's observations it
is not a science any more.

If you have a GP or ENT that does differs from the above and will
treat you to get rid of the infection
while trying to maintain the integrety of your nasal structures then
CHERISH THEM, cause I have reasont to believe they get a lot of flac.

On 3/13/07 11:41 AM, in article 6fCJh.1091$qe5.877@trnddc05, "MS"
<ms@nospam.com> wrote:

The MRI of the sinuses is of little value. It is much too sensitive to
fluid, mucus and a bit of mucus lights up like bad disease. There is a
terrible waste of time and money because the MRI is taken for something else
and the diagnosis of sinus disease is made based on a bit of mucus in the
cavity and so an unnecessary visit to the ENT to tell the patient "its
nothing". Whereas a CT will tell abnormal anatomy, show details of polyps,
show bone erosion, etc. An MRI might be useful in dirrentiating a fluid mass
from a fungal mass, but that's it.
The proper way to dx a sinus bacteria is to actually enter the sinus opening
and aspirate the purulent material.  A less accureate but effective way is
to use the pulsatile irrigator and catch the second 200 cc of irrigation in
a sterile container.
This is why no ENT take MRI of the sinuses and cringe when the patient
wastes a trip for explanation of the sinus diagnosis due to the MRI.