Hello doctor, I am 59 years old. I have asthma for five years and taking Seretide for that. Over the last few months, I have been having serious allergy problems (sneezing, runny nose) and for some time I lost my sense of smell but it seems it is getting back after I started taking some steroids (Solone) and Nasacort nasal spray and sinus wash over the last two weeks. I had a CT scan of my face taken last year. I have polyps in my nose as well. I am getting mixed messages from various doctors about what would help me. Some are suggesting surgery. But I am worried about the surgery. Based on the CT scan of the face and the nasal endoscopy (attached), what would you recommend? Is surgery essential? If surgery, what kind of surgery is needed, please mention the names of surgery.
Hello. I have gone through your complaints and your attachment files. (attachment removed to protect patient identity). This is suggesting allergic polyps in the nasal cavity along with some sarcoidosis pictures in the lungs. Sarcoidosis is a chronic granulomatous condition that can be treated only by steroids that you are already taking. But polyps in the nasal cavity requires surgery to be done to get relief. You require to undergo minimal functional endoscopic sinus surgery which is done using a nasal endoscope. Even though you have inferior turbinate hypertrophy and deviated nasal septum with a spur in septum septal surgery (septoplasty and turbinate resection) are not required in view of sarcoidosis in your lungs. Minimal endoscopic sinus surgery with polypeptide followed by medication will be required for your condition.