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Sinus surgery - is this odd?
Old 07-17-2007, 05:58 PM   #1
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Sinus surgery - is this odd?

I've been seeing an ENT for loss of taste/smell. CT scan shows all sinuses plugged except for the left maxillary sinus (below the eye). Nasal steroids haven't helped the taste/smell.

Endoscopic surgery has been scheduled (I'm all for it). However, the Doc only wants to scope the maxillary (below the eye) sinuses. I asked "Why not the frontal (forehead) sinuses also"? His answer was they are "Hard to get to". I know there is a small risk of brain injury, but is this a standard answer or does this sound like I might not have the right Doc?
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Old 07-18-2007, 07:44 AM   #2
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CAT.INIST

This paper suggests that to get an endoscope into the frontal sinuses you need to remove the ethmoid first. The ethmoid, I'll have you know, is a skull bone.

Do you really still want to explore up the Amazon?

Disclaimer: ENT is not my area of expertise.
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Old 07-18-2007, 08:18 AM   #3
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Originally Posted by gindie View Post
I've been seeing an ENT for loss of taste/smell. CT scan shows all sinuses plugged except for the left maxillary sinus (below the eye). Nasal steroids haven't helped the taste/smell.

Endoscopic surgery has been scheduled (I'm all for it). However, the Doc only wants to scope the maxillary (below the eye) sinuses. I asked "Why not the frontal (forehead) sinuses also"? His answer was they are "Hard to get to". I know there is a small risk of brain injury, but is this a standard answer or does this sound like I might not have the right Doc?
Frontal sinus surgery entails additional risk as Meadbh implied.

As a nonexpert in the field of "functional endoscopic sinus surgery" (FESS) a quick review of the literature reveals insufficient evidence either way to come to a firm conclusion as to whether such surgery improves the sense of smell.

Be aware that there are reasons for loss of olefactory (smell) sensation besides the sinuses, including aging (sorry) and a few other conditions. You might ask your primary doctor about those before making a final decision.

There are a few centers which have special interest in this, including the U. of Connecticut Health Center.

Good luck whatever you decide.
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Old 07-18-2007, 10:14 AM   #4
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Unless i'm misremembering, the nasal steroids like flonase actually reduce sense of smell. I know my sense of smell all but disappeared when I started using them.
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Old 07-18-2007, 10:26 AM   #5
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Unless i'm misremembering, the nasal steroids like flonase actually reduce sense of smell. I know my sense of smell all but disappeared when I started using them.
Probably coincidence; in allergy situations in can improve small dramatically, though it takes several days to work. Maybe you noted that in the first few days as your allergies or nasal polyps progressed on their own.
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Old 07-18-2007, 01:18 PM   #6
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To clarify the Flonase thing, CFB correctly points out that Flonase and its cousin drugs can temporarily blunt the sense of smell (I think because of the carrier stuff in the liquid). Ironically, though, it is a good treatment for loss of sense of smell from allergies involving the nose. I may have wrongly assumed that CFB permanently or long-term lost his sense of smell when he took Flonase (not a likely side-effect).

So, you might get temporarily worse (from the Flonase coating the tissue) before you get better (from the steroids in the Flonase suppressing the allergic reaction).

I've got a nose for this stuff.
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Old 07-18-2007, 01:35 PM   #7
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Probably coincidence; in allergy situations in can improve small dramatically, though it takes several days to work.
A lot of guys (and gals) won't mind waiting a few days to get results. Especially if the increase in size is dramatic.
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Old 07-18-2007, 03:45 PM   #8
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Here are some interesting stories about smell.

In the book Surely You're Joking, Mr. Feynman! (Adventures of a Curious Character), the author tells about hearing about how good a dog's sense of smell was. He decided to see if maybe humans' smell was pretty good too. He had his wife handle one of the books in the bookcase while he was out of the room, and was able to tell which one by sense of smell. I've tried this also, and was able to do it.

In the book The Man Who Mistook His Wife For A Hat: And Other Clinical Tales the author tells of a grad student who had a brain tumor. One of the symptoms was that his sense of smell became incredibly acute. He said that he could walk into a room and tell from sense of smell all of the people who were there. He could tell whether a woman was menstruating.

Both of those books are recommended.
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Old 07-18-2007, 03:48 PM   #9
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He could tell whether a woman was menstruating.
I can tell that without sniffing. I think its the wild look in the eyes, the sharp knife in hand, and the "GIMME SOME $#%^ING CHOCOLATE YOU ^@#$#!!!" tips it off.
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