You have sinus disease and need and ENT evaluation
Based on the CT scan report you have sinus disease that needs therapy. I advise you to see an ENT. You may need allergy therapy or nasal sprays to clear this up. It is possible you will eventually need surgery on septum and turbinates but we can not determine that without an exam. Do not go straight to a rhinoplasty as this will not address your medical issues. Hope this helps.
Septoplasty and Turbinate Surgery Is for Breathing, Rhinoplasty for Appearance
Forget cosmetic nasal surgery. Rigth now your priority is to fix the nasal interior. Sound like you have had big-time problems with your sinuses which usually comes from a blocked nose. The most common cause of blocked nose is deviated septum with or without turbnate enlargement.
Here is my advice: See a head and neck surgeon ( ear, nose and throat trained ). He or she will review the x-rays and advise you as to the extent of your problem. You may well need some surgery to clear the sinus problem; perhaps can be done at same time as the airway opening work.
If all goes well, then consider rhinoplasty.
-Robert Kotler, MD, FACS
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
Nasal surgeries that improve breathing
- A deviated nasal septum causes nasal obstruction on the affected side and cause headaches if there is a bone spur formation further posteriorly. During a septoplasty the septum is straighten to allow proper breathing on both sides of the nose.
- Turbinates are normal tissue swellings on the inside of the nose that cycle from left to right, there are three turbinates on each side of the nose. The inferior turbinate is the most significant one that alters the breathing apparatus. If needed, turbinates can also be trimmed back, out-fractured and pushed laterally to further improve the airflow dynamics through the nose.
- Any sinus issues such, as chronic sinusitis has to be addressed through endoscopic sinus surgery. Polyps can grow inside of the sinuses, causing headaches, facial pain, pressure and repetitive sinus infections. This is usually related to allergies.
- A rhinoplasty is performed on the nose for cosmetic purposes only and can be done simultaneously with the above procedures per the patient’s needs, wishes and desires. Rhinoplasty is not done for functional reasons.
Treatment of deviated septum, enlarged turbinate and frontal sinusitis.
You will have your airway made better with a septoplasty and turbinate reduction. However, the frontal sinusitis is potentially a more serious problem. You should see an experienced ENT surgeon to deal with all 3 problems.
As a nose surgeon, I have the privelege of looking into several noses a day! It is always surprising how many people I find who have a deviated septum and virtually no complaint of nasal obstruction. It is equally surprising how many patients present with the complaint of nasal congestion or obstruction who show virtually no sign of impingement in their airway by the septum.
Regarding your CT scan: an accurate physical exam is far more useful than a CT scan in diagnosing and determining candidacy for correction of a deviated septum. In this case this serves mainly as a confirmation of your physicians findings.
Nonetheless, the septum is frequently deviated, and in patients who experience nasal obstruction a septoplasty can be very helpful. In most of these cases there is some degree of turbinate hypertrophy that can easily be treated using simple turbinate reduction procedures while in surgery for the septum.
Rhinoplasty most often refers to a procedure that would affect the external appearance of your nose. This does not sound like what you need.
Septoplasty and turbinate reduction for breathing difficulties and sinusitis
It appears that you have bilateral disease and may benefit from both procedures in order to alleviate your right frontal sinus and left maxillary sinus disease. Septoplasty alone may not correct the left sided disease but this could be improved with medications. There is some controversy with turbinate reduction as some physicians believe it can create a dry nose condition (rhinitis sicca) and therefore partial reductions are more popular.
Septoplasty plus turbinate reduction.
Presuming that appropriate medications have been tried, I usually find that a septoplasty plus partial turbinate reduction has a high success rate for relieving nasal obstruction. Of course, it depends on the patient's specific anatomy. Some require only turbinate reduction while others require only septoplasty.
My only general advice is to avoid turbinate *removal*. The turbinates are important structures for warming and humidifying the air we breathe. Most of us take care to reduce the turbinates' volume, but not their surface area.
All the best,
Somnoplasty or Septoplasty for Enlarged Turbinates with Deviated Septum?
It is possible to reduce your inferior nasal turbinate volume with Somnoplasty (radio-frequency volumetric tissue reduction) in a 30 minute in office procedure under local anesthesia. In many cases, that is all a patient needs to correct their nasal breathing problem. If after 4 to6 months there is continued nasal breathing difficulty, then a formal septoplasty operation can be performed.
Since I have been using Somnoplasty of the inferior nasal turbinates, my septoplasty rate has dropped by about 75%.
Rhinoplasty is for cosmetic improvement of the nose only.
Good luck and be well.