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What Causes Recurring Pressure In Nose Post Partial Bilateral Turbinectomy?

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Posted on Fri, 4 Sep 2015
Question: I had a partial bilateral turbinectomy fess and an ethmoidectomy done in March. I don't remember consenting or agreeing to the ethmoidectomy just the turbinate reduction. since then I have been on numerous antibiotics, prob one every 4 weeks as soon as I get off one the symptoms come back. I have insane amount of pressure in my nose, no sense of smell and sound really nasally and at times blow out light yellow drainage as well as clear drainage a lot. Each time I'm on an antibiotic I have to also take an anti fungal as I develop a white coating and raise papillae on the back of my tongue. At times I can feel tons of mucus post nasal and have to clear my sinuses by snorting it in the back of my throat and spitting it out. I am having extreme anxiety over going back to the ent dr and have developed depression because I feel that something just isn't right. I was told the surgery would take 45 min, 3 hours later I was still in there according to my sister who took me. Idk what to do, I'm miserable depressed and overweight due to the steroids and antibiotics. I have 3 kids to take care of and would like to get in an excercise program. What are your suggestions? I feel as though I need a second opinion, I'm scared in going to die from something that I thought would be helpful but so far has been the worst nightmare I've ever had. I feel that something went wrong with the surgery! Also every time i go to the office I get charged for endoscopic surgery because he looks in my nose with a metal scope and sometimes auctions my nose. Please help! Any answers at this point would be helpful!
doctor
Answered by Dr. Sumit Bhatti (3 hours later)
Brief Answer:
Repeat Sinus CT. Hypertonic saline nasal washes. Steroid sprays.

Detailed Answer:
Hi,

Thank you for your query.

1. Repeat a plain Sinus CT and upload the images here. Upload any pre-op images for comparison. Images from the nasal endoscopy will also be helpful.

2. Hypertonic saline nasal washes should be effective in decreasing your symptoms.

3. Uses nasal steroid sprays to avoid systemic side effects of steroids. An anti-allergic, mucolytic medication with seam inhalation is recommended.

4. Chronic Rhinosinusitis, Post nasal drip are a quality of life issues and are not life threatening at all.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (8 hours later)
What medications do u recommend i have used flonase and azelastine singulair allegra i also rinse with distilled water one saline packet and alkolol daily if not twice a day! Feel good in the morning but by time i go to bed i can feel a pulsating sensation in my nose!
doctor
Answered by Dr. Sumit Bhatti (5 hours later)
Brief Answer:
Meds are ok. Hypertonic saline. Upload CT images.

Detailed Answer:
Hi,

Thank you for writing back.

1. Your medication is fine.

2. Use hypertonic saline for the nasal wash.

3. The pulsating sensation signifies blocked sinuses. Upload the latest CT images along with the older ones for comparison.

4. 'Biofilm' formation is one of the causes for such symptoms. This would include fungal infections.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Sumit Bhatti (17 hours later)
I dont have the ct images they are at my md office. I went to ent dr yeaterday and he said their is an obstruction and puss in my right nostril. He also said that the last time he cx it the cx came back as a beta lactamase bacteria, i cant remember the name of it though. He cx my right nostril again, prescribed omnicef for 10 days, wants me to continue nasal irrigation and come back in 10 days. He stated if it doesnt clear up and if he can still see the obstruction then he will go back and use a micro debrider to clean up the right side. He said the left side looked great. Do unthink this sounds like the right course of treatment? I have read about beta lactamase (anxious right now) and the literature says that a combination of two abt should be used. Im really scared that this may turn into an esbl infection. Idk what to do! I am a mom and a rn i have to worl and take care of my kids. I dont want to become septic and die!!
doctor
Answered by Dr. Sumit Bhatti (4 hours later)
Brief Answer:
Septicemia should not be a cause for worry for you.

Detailed Answer:
Hi,

Thank you for writing back.

1. Ideally, the antibiotics should be decided as per the culture & sensitivity (C/S) report.

2. Yes, if the C/S report permits, two antibiotics are a better option for resistant strains. An infectious disease specialist should be consulted. ESBL bacteria can be managed by intravenous medication. Septicemia is a remote possibility. Do not worry.

3. The scan images are important for planning the treatment.

4. Radio-frequency ablation of the obstructing tissue is a better option than a microdebrider.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2686 Questions

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What Causes Recurring Pressure In Nose Post Partial Bilateral Turbinectomy?

Brief Answer: Repeat Sinus CT. Hypertonic saline nasal washes. Steroid sprays. Detailed Answer: Hi, Thank you for your query. 1. Repeat a plain Sinus CT and upload the images here. Upload any pre-op images for comparison. Images from the nasal endoscopy will also be helpful. 2. Hypertonic saline nasal washes should be effective in decreasing your symptoms. 3. Uses nasal steroid sprays to avoid systemic side effects of steroids. An anti-allergic, mucolytic medication with seam inhalation is recommended. 4. Chronic Rhinosinusitis, Post nasal drip are a quality of life issues and are not life threatening at all. I hope that I have answered your query. If you have any more questions I will be available to answer them. Regards.