 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / Diseases and Disorders / Sinusitis / July 2007Criteria for Turbinate Surgery
So my ENT doctor tells me that I should have turbinate reduction surgery (cut out tissue and work on the bone). The second opinion of another ENT doc who I respect does not believe that surgery for me is absolutely necessary, but still a good idea, considering my nasal structure. I tell them that turbinate reduction surgery worries me, because I have read stories, on this website and others, about surgery messing up the turbinates and leaving the patient with even worse problems than before. Once you reduce them there is no going back. These doctors assure me that those incidents are rare and a thing of the past. So now I don't know what to do. On one hand, I read horrible stories about people having messed up turbinates for life due to surgery; on the other, these docs tell me that this surgery could greatly improve my airflow and help me deal better with allergies, etc, and basically help me feel better in general. I would love to not have to deal with congestion, allergies, infections. I also dread the possibility of those things being worse. Can anybody offer any good and balanced criteria for deciding to have surgery??? On Apr 29, 6:47 pm, octo...@hotmail.com wrote: > So my ENT doctor tells me that I should have turbinate reduction > surgery (cut out tissue and work on the bone). The second opinion of [quoted text clipped - 21 lines] > Can anybody offer any good and balanced criteria for deciding to have > surgery??? I only know what I read. The old Wacking and scraping had only about a 50/50 outcome. Fess is supposed to have about a 85% positive outcome after a year, according to a German study, with post op infection being fairly frequent. And then there is Transcutaineous turbinate RF oblation, also called Somnoplasty which seems to have an even better record of making things better, and seems to give a shot of getting a working snoz that will still be self-cleaning at the end. I think the RF skins on the surface and there is a decent chance that it will kill the biofilm in the vacenity which will lessen the chance of post op infection. Anyway the worst said about it is that, 1. The Blues may not pay for it, and 2. It may have to be done over again if enough is not done the first time. Doc can give you more info. > So my ENT doctor tells me that I should have turbinate reduction > surgery (cut out tissue and work on the bone). The second opinion of [quoted text clipped - 21 lines] > Can anybody offer any good and balanced criteria for deciding to have > surgery??? I had turbinate reduction therapy but with a laser, and the ENT did not cut out tissue or work on the bone. The procedure took about 10 minutes. They numbed my nose, so I felt nothing. It was done out patient, and I was able to drive myself home. Since having this done, it's been like heaven. My nose is never stuffy. I have no problems breathing. It's been a miracle. My ENT said he would do just a little, and then if I had further problems, he would do more. He hasn't needed to. My problems seem to be over. I had 4 different ENT'S who did CT scans, who all told me that I had sinisutis. Fact is, it was swollen turbinates and the sinuses are fine. HTH > > So my ENT doctor tells me that I should have turbinate reduction > > surgery (cut out tissue and work on the bone). The second opinion of [quoted text clipped - 36 lines] > > - Show quoted text - The one guy that I know personally that was totally happy with his sinus surgery had had turbinate reduction by image guided laser. The swollen turbinates block drainage from the sinuses. When the main drain is clogged, everything backs up. Thanks all for your input. I think I will have to do some more research. The ENT told me he is going to simply cut out some of the turbinate tissue and then reduce the bone (plus straighten the septum and remove the turbinate spur), but reading above it sounds like there are more options. >From what truehawk has written, I think that maybe the dangers are not as bad as I thought. True, it would be bad to go through an expensive surgery and unpleasant recovery, only to find out there is not much longterm improvement. But for me that pales to the fear of the surgery making things worse, and causing irreversible damage. Like I said, I have read some bad stories, but more and more I'm getting the impression those are rare. Truehawk, how do you access most of your information? Just through the internet or do I have to go check out some medical journal? It is all on the net. I used to get pounds and tons of journals, not I just read them on line unless I need something from before 1985. http://www.Pubmed.gov is a government database that indexes pretty much all the world's medical journals. Suggested sreach terms: Biofilm Sinusitis, macrolides for sinusitis, osteomeatal complex, nasal valve. and whatever the technical term they are using for the method of your surgery plus "outcome". American Family Physician http://www.aafp.org/afp/980901ap/slack.html http://www.ScienceDaily.com http://www.Sciencenews.org pick up news releases from the Collages and Universities. http://www.medicinenet.com/nasal_airway_surgery/article.htm The things that can go wrong page is preticularly detailed here. http://images.google.com/images?svnum=10&hl=en&gbv=2&q=osteomeatal+complex&btnG= Search+Images Click on any image to go to the artical. http://www.seattledoctors.com/sinusitis.asp Good images of what they are probably going to do. http://www.fluent.com/about/news/newsletters/03v12i2/a11.htm location of the nasal valve, the narrowest part of your breathing system, which I think allows some pressure to be built up in your lungs during exhaling that facilitates oxygen diffusion into the bloodstream, which is why you extract more oxygen from a given volume of air if you breath through your nose than through your mouth. Airflow wise a healthy set of sinuses is damn elegant. Hope this helps Elizabeth On Apr 30, 11:20 pm, octo...@hotmail.com wrote: > Thanks all for your input. I think I will have to do some more > research. The ENT told me he is going to simply cut out some of the [quoted text clipped - 13 lines] > Truehawk, how do you access most of your information? Just through > the internet or do I have to go check out some medical journal? Okay, thanks again for the information. I've gone to three ENT's and they all endorse the surgery, so I guess I'll do it even though I still have questions. True, my turbinate tissue is immensely swollen so I see the need for removal, but no one has given a truly satisfactory explanation of why, IMO. Allergies is the standard response, and while I do have allergies, I am 27 years old and never in my life have my turbinates simply swollen up for several months. I know when I'm around an allergen, because I'll get red eyes, sneeze, all that stuff, but my nose is continuously swollen, 24-7, regardless of environment. I suppose I am the type of person who always wants a full explanation, and maybe there just often isn't one when it comes to the nose and allergies. Reading all the articles that truehawk referenced was very interesting (having a physics degree, liked the one using fluid dynamics to model airflow through the nose). Basically what I learned from it is that medical knowledge about the sinuses, allergies, treatments thereof, is still incomplete with a lot of new techniques being constantly tested. So you pretty much have to accept doing a surgery knowing that results are not 100% guaranteed and there are risks but that usually it means an improvement. On May 12, 10:24 pm, octo...@hotmail.com wrote: > I've gone to three ENT's and they all endorse the surgery, so I guess > I'll do it even though I still have questions. True, my turbinate [quoted text clipped - 16 lines] > that results are not 100% guaranteed and there are risks but that > usually it means an improvement. Does not one of your three ENTS offer laser or Radio Frequency ablation? People who had those are happier than those that got cut the old traditional way. Also discuss how they intend to splint your nose if they are going to do septaplasty, (you don't want it packed if you can help it) and what antibotics they intend to give you pre and post op. If they say Amoxicillian, I would strongly advise another ENT. You want someone who knows enough to prescribe azithromycian (Zithromax) or clarithromycian (Biaxian). What post op-antibotic they are willing to prescribe and for how long, can greatly affect the length of your recovery. You also might want to make sure that your doc is not going to do the surgery and then go on vacation. And I have heard that surgery on a Tuesday has better outcomes than surgery on a Friday. No, none of them mentioned laser or radio frequency... I do not know if that is an option when they are also going to reduce the underlying bone, and one doc's opinion was that one technique is about as good as the other-otherwise everyone would be doing the best one. They will do some packing but I've been assured it's a lot less than the usual amount. Why would surgery on Tuesday be better than Friday? Docs less tired at the beginning of the week? On May 13, 4:32 pm, octo...@hotmail.com wrote: > No, none of them mentioned laser or radio frequency... I do not know > if that is an option when they are also going to reduce the underlying [quoted text clipped - 6 lines] > Why would surgery on Tuesday be better than Friday? Docs less tired > at the beginning of the week? Octo: Doctors have families and children and like to take the weekend off too. You want to maximize the chances that you can get seen right away if you need him/her. The wrong post op infection in that area can wreck havoc on you while you try to find a doctor At worst, it could cause a Jim Henson. Also if he is going to cut, it is really nice for him to know exatly where. Computer assisted, image guide systems help minimize collaterial damage. And yes, Image guided lasers and RF systems have lower infection rates than slice methods. Check out everything you can up front, and get some agreements about your aftercare. Once we were all young, and trusted our doctors implictly. When I was your age I had a much more complacient attitude than I do now. After collecting a few metaphoric dectorative doctor dozer marks on the back, I would bring a along a jewish mother who is also a wedding planner and a Master Sargent in the Marines to keep from being run over and work out the details if I could find such a person. -ell, I would hire the doc's mother.! I fanticize that I am not that easy to run over but they flip their hand and scoff a bit, and make you feel stupid for asking, and then a couple of weeks later, you are trying to breath through green goo and can't find them because they have gone rafting down the Colorado, or sking at Vail or are competeing in the Whitbread. This does not happen to everyone, but I know several people it has happened to. Is it worth taking precautions to avoid? Having been through a few surgeries (non-sinus related so far) I too have seen the good and the bad. I have done a fair amount of checking and researching (been to 6 ENT's, looked up their records, etc) and while my knowledge of the turbinate surgeries is only fair, this doctor is supposed to be a pretty good surgeon. I will ask him some of your questions in the pre-op visit, so thank you for that. It is quite vexing when a doctor blows you off, but I do not entirely blame them. The medical and insurance system in this country definitely has some sore spots. Doctors have to cooperate with insurance companies (some of whom make very large profits) and seldom have the time to give any one patient thorough attention. They certainly do not like it when patients ask too many questions or doubt their decisions.... but I imagine I might get impatient after dealing with that all day myself. Even so, some of the ENT's have definitely irritated me. Like one who originally told me I do not need surgery, then I came back months later for a second opinion and he says, "Well, if that ENT recommends surgery, I think it is a good idea." Definitely an "auto-pilot" mentality there.... I think I'm going to try to find an ENT who does that laser surgery. I still don't agree with my ENT on bone removal, since when I am decongested I can breathe fine. I don't suppose there good way to find an ENT who does specific surgeries or techniques (laser or anything else)? I guess I'll just go down the list and call their offices to ask.... Well, it's finally happening, I am having surgery next Thursday. I put it off as long as I could, but the turbinates are still swollen (and septum still crooked of course) and enough is enough. I would like to thank everyone for all advice, especially truehawk, even though she would probably be mad at my choice of doctor :) He might not be perfect in every detail, but he is a cosmetic surgeon along with an ENT, so at least he should know how to cut. The other ENT's say he's fine, so I feel confident. After the recovery I will be sure to post to let any other surgery candidate know what to expect. On Jun 28, 2:41 pm, octo...@hotmail.com wrote: > Well, it's finally happening, I am having surgery next Thursday. I > put it off as long as I could, but the turbinates are still swollen [quoted text clipped - 7 lines] > be sure to post to let any other surgery candidate know what to > expect. Okay I will be mad if I must, but seriously I hope that he is using a laser or some other self sterilizing method such as radioablation so that you don't have the post surgery infection to deal with. > On Jun 28, 2:41 pm, octo...@hotmail.com wrote: > [quoted text clipped - 14 lines] > such as radioablation so that you don't have the post surgery > infection to deal with. I don't think he is using a laser .... he will reduce the turbinate bone and then cut away some of the overlying tissue On Jun 30, 10:18 am, octo...@hotmail.com wrote: > > On Jun 28, 2:41 pm, octo...@hotmail.com wrote: > [quoted text clipped - 17 lines] > I don't think he is using a laser .... he will reduce the turbinate > bone and then cut away some of the overlying tissue I'm hoping for the best for you!!!!!!!!!!!!!!! Thanks! |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.