Maxillary Fungal Sinusitis

[monsterHighliv]

ewww but it does help

[NoseMD]

@monsterHighliv U bet ...cured this patient.

[SinuSoothe]

Our nasal spray contains potent natural anti-fungal ingredients and has cured many people with fungal sinusitis.

[appleglory]

my nose feels clear after watching this video.

[AussieVR4]

Pretty sure doctors are awesome!

[TheFoxandTheRabbit]

you are wonderful. And you saved her, then ? i hope. I had to have septo- rhinoplasty to be able to breath from nose agin proper. Since then, i have had infections, and in last 6 months a foul smell from ? I am not sure . the surgury was on 10-25-2010.

[SweetyDazzle]

I was only watching this for my science project

[GrandpaMosh]

What are concretions?

[NoseMD]

@GrandpaMosh fungus in this video

[kronk99]

Dude.....You are awesome. Period.

[irfan424]

GUUD ONE



[fayeteville]

id like to know if u perform caldwell luc or endoscopic mini caldwell as part of the surgical treatment in patients with fungal sinusitis ( maxilary) and inverted papillomas- ive seen recurrences even in patients that ive performed a wide antrostomy -

iverted papillomas recurrence is a challege for ENTs

M. ledesma MD  ENT

[VeggieTrunks]

It's weird that tearing all this stuff in her nose doesn't have a consequence. Is all of that tissue not necessary? Not trying to sound dumb =(

[rudcalder]

fucken awesome

[aristo2080]

the tool like a di*k :)

[HappyBirthdaySANTA]

how long on average is this surgery.. i don't think i have this, my symptoms indicate that i might have TMJ/TMD.. i hoping it this over TMJ/TMD.... really over having to deal with the shit hand i got dealt in life...

[bitchoff1]

I love watching these nasal videos. I find them to be quiet interesting and educational. Also I love watching gross stuff. The more gross the better. Keep'em coming nasal lovers.

[amoripaz108]

Dear Nose MD, I had maxillary sinus surgery a year ago for a completely opacified right maxillary sinus at Kaiser. Six weeks later I had a CT scan that showed the sinus was again opacified though my ENT surgeon had removed an aspergillus fungus ball. He said I had bad luck and that the next step was a Caldwell-Luc procedure. This sounds extreme and I am wondering if you have an alternative suggestions. Many thanks!

[NoseMD]

@amoripaz108 I rarely perform a Caldwell Luc procedure. However, if the surgeon feels this his best way to remove the fungus in his hands then so be it. My video describes transnasal approach. I would also access below the inferior turbinate (Inferior antrostomy) prior to opening the anterior (front) wall.

BTS MD

[sdchargers4life1]

What are the symptoms of this disease. I've been having this pressure on my.forehead and my nose is always clogged up and throat always sore...

[AlienBeauty1]

why is it that when the Dr send out the samples of the dark green stuff that comes out my sinus it tests negative for fungus/mold?

[prosenfi]

What are the concretions made of?

[pris72]

So I have been diagnosed with chronic left maxillary sinus disease, which has caused bony changes. I have been on every antibiotic known to man, saline sprays daily and flonase now. Still have issues. I see my ENT for another appt. later today, and I am just going to ask him what the next step is. I am 38, and have had sinus problems since I was a kid. Tonsils and adenoids removed at 7, and tubes in my ears 2X. History of these issues. Surgery may be my only option at this point. : /

[sngstr86]

@pris72 i believe i have the same disease. maybe yours is fungal in origin as opposed to bacterial. and it's been there for a long tiem too.what do u mean by bony changes? referring to Silent Sinus Syndrome? the procedure looks quite invasive and opening the sinus that much gives me concern. once it is aerated will the bony changes go back to normal?

[NoseMD]

@pris72 There are no bony changes seen radiographically or endoscopically. Opening the sinus was minimally invasive as oppose to removing the entire medial wall of the maxillary sinus to remove the fungus. Silent sinus syndrome is caused by obstruction of the outflow tract and requires a similar operation depending on the contents of the sinus. I would agree the smallest possible opening at the natural opening is best, but removing the contents is just not possible thru such a small opening

[SirWimpie]

At this point, the patient is terminated.

[theothawhitemeat]

@ RMageddon10 :( man that sounds painful I'm sorry.

[terveron]

How do the lateral walls of the nasal cavity heal afterwards?

Are the reconstructed with any material or just left to heal by their own?

And one more thing, when I was watching the procedure I had the impression the surgeon mostly misses the view over the anterior wall of the sinus. Is this true or it's a wrong impression? Thank you! :)

[RMageddon10]

I think ive had the worst case out of anybody. 4 years ago i head surgery for fungal sinusitis and a neurosurgeon actually had to make an incision around my face, pull it down and remove a skull portion right in the middle of my forehead because that area was so infected. The surgery took 12 hours and i had to get two more surgeries after that because it kept growing back. Not as severe as the 1st surgery though. My last sugery was about 3 years ago but i think it is coming back again :(

[88UTUBENAZI88]

@RMageddon10 hi....just querious did yu hav bad sinus pressure feeling? i have snisitus and sinus cyst and hav had infections for yrs now,,,i suffer major pressure issues...am useing sinus flust now and haveing no success.....my ent doctoe said course of surgery will be insertion through the side of my face...similar to your surgery....do you regret the surgery? did yu hav any major post surgery issues?

[RMageddon10]

@88UTUBENAZI88 Hey, well I really didnt have a choice not to get it because it may have possibly been lethal. Just do with you have to do to get rid of it, I took me a while to get used to my scar but you'll live with it eventually. Im doing fine now btw, I had surgery last month and im gonna do everything I know of to keep it from returning

[88UTUBENAZI88]

@RMageddon10 lethal? in wat way if you dont mind me asking? were the cyst pushing on the sinus wall? scars are not an issue for me...im more worried about post surgery bleeding....

[anglsageyayo]

I have had this horrible case of sinusitis for over two months now. Antibiotics, allergy meds & nasal irrigation have not helped. This video has me a little freaked out! Hehe I guess it's time to get a referral to an ENT. Very interesting video! Thanks for sharing.

[WhiteSage777]

How much does this surgery cost if you have no insurance?

[AlienBeauty1]

many times after surgery patients are good for about 1 years then have have a relapse.

[Mhenge]

Did this woman have anything left, after this procedure, or....? Just saying.

[Arnold1117]

After watching this I wonder, should everyone have something like this procedure done if you've ever had a sinus infection or something that involved your nose being runny for a long period of time? Does the average person have some kind of blockage in their nose and just don't realize it? If that average person were to have blockage, would it ever go away on its own or with some kind of medication? I am now paranoid about my nose. Should I have my nose cleaned after a sinus infection?

[NoseMD]

@Arnold1117 You only need this procedure if there is evidence of infection by history, exam and imaging studies. The average person does not have this problem or anatomical problems in their noses. Though 37 million Americans suffer with chronic sinusitis, most sinus infections clear on their own. Some require over the counter meds (saline rinse) others may require antibiotics. Only a few, but a significant number (300,000/yr), require surgical correction in the USA . Dr.Schaeffer New York

[anthonisaac]

Thanks for posting this. I appreciate seeing what these surgeries entail!

[einnej34]

is the thickening natural flesh thickening or a result of the fungus?

[MrRandym81]

Cavity she made bigger during first surgery.....she did not use cudwell/luc or other sinus incision? Would that be possible to miss or did it most likely form post op? Seems quite fast. We are going to try anti fungal approach for a week or two to see if we can get it to shrink and come out. Asspri. outgrew petri. Should I just do another FESS and skip antifungals?

[MrRandym81]

I had FESS for fungal ball presenting with pink/blood tinged mucus. On 1 month follow up Dr found another fungal ball on endoscopy that would not fit through

[NoseMD]

@flanksteak2 Not sure what your are describing.  Needs to be seen. See a nose doctor

BTSMD

[NoseMD]

@adrinna082 Indeed see the ENT. More than likely you have a sinus infection which requires antibiotics. A thorough ENT exam is necessary first. Good luck.

BTSMD

[AlienBeauty1]

@NoseMD but if it is fungus antibiotics will make it worse

[AlienBeauty1]

I have been battling this for more than 5 years and it is very frustrating, I send samples of black/green stuff that comes out my sinus and no doctor can identify it as mold , even though I am certain that is what it is !

[MrRandym81]

Now I am signed in under the correct user name :) - Sorry for hijacking the thread.

[doinurmom120]

Just noticed I'm singed in under another user.....please forgive the screen name:)

[doinurmom120]

Of course, I've talked myself into thinking she's going to find come malignant mass that's aggressive and hard to treat. Not just the squamous cell variety, but more like melanoma or a small cell typed metastasized deal from my brain....Unlikely? Doc told me not to go but any additional life insurance :) but I'm still a wreck. Going under 1/14 at U of MN. Can't wait to get this behind me! Again, your video has given me some additional hope to thanks again for posting it!!

[doinurmom120]

I'm having surgery for the same thing as this lady. Only one symptom (Blood Tinged post nasal stuff). Same look on the ct with partial opacification of L maxillary sinus with some central calcifications. No bone invasion, or erosion, although my ct is similar with the look of increased density of bone in the infected sinus. My doc tried to dx fungus prior to surgery but just sees pus coming from maxillary. Glad I found your video.

[javajunkie101]

I am glad you were the one to rectify this situation. This surgery looked very delicate and a bit complicated. It was fascinating to watch. Is she fully recovered with no relaspe?

[NoseMD]

@javajunkie101 The patient is doing well. No relapse. Thank you for your comments.

BTSMD

[smithson876]

oh man I bet she felt wicked good after he cleaned that out of there haha. lucky

[NoseMD]

@smithson876 Yes she did feel much better but you missed one point in this story. It wasn't lucky...she had been to two previous surgeons who didn't recognize the extent of her problem. Not luck..she was fortunate

BTS MD

[smithson876]

@NoseMD Yes I agree. Of course you aren't lucky when you get an infection like that. But she is lucky (or fortunate) that she got something done. I have had nasal problems for as long as I can remember. I can only ever breathe through one nostril, often breath through my mouth and am constantly stuffed up. Whenever I go to a doctor they never seem to take it seriously. I just wish i could get it all tidied up in there! I don't know how to go about it though.

[TheLockerzAddict]

the long thing at the beinning looks likea dick

[ableite]

there is a face on 2:46

[millrhighlife]

I have also watched a lot of your surgery videos. Over the course of my life I have suffered numerous sinus infections. At what point in time would you consider or offer this as treatment to a patient and how would someone go about exploring these options? I have been unable to breath out of both nostrils simultaneously for a number of years now.

[NoseMD]

@millrhighlife Greater than 4 infections a year

[Nimbology02]

2 Rival Otolaryngologists voted dislike, it's a cut nose industry.

[ITRlover1]

did this cause a weird smell to come from your nostril prior to surgery?

[laaapower99]

Nicee! This is interesting! I kinda feel like being a doctor. But nah. xD

[hoogleyboogley]

Have you had patients that have an odor that is similar to a stagnated wet towel smell coming from their nose and mouth? Do patients with Fungal Sinusitis eminate a similar aroma? Thanks

[napalm940]

@hoogleyboogley I deal with severe sinus congestion and frequent infection.After thoroughly rinsing my sinuses,I often experience a weird smell,alot like a stagnated wet towel.Any thoughts?I am asking you because you described the smell exactly.

Thanks.

[NoseMD]

@hoogleyboogley Bacterial, amerobic and fungus can have an odor

[WhiteSage777]

@NoseMD I think fungus usually has the most noxious odor

[hypersupermamado]

what was her symptoms ???only mucus tainted with blood ?

[godsephro]

Breathe easy now buddy

[alexrowland]

This is the 5th or 6th video I've watched of various nasal surgeries and in every one it seems they remove a lot of tissue and bone. Does the patient feel any difference after full recovery? Is full functionality returned after recovery?

And what's the worse case scenario if this particular fungal infection is left unchecked? Cancer? Does it eat away at the surrounding tissue?

These are making me second think med school. The human body is so interesting. Good job on the successful operation.

[NoseMD]

@alexrowland What was removed didn't belong..the fungus. Patient felt much improved. Worse case scenario..fungus spreads to face, brain or eye. This particular case is pretty indolent (not aggressive), just annoying.

BTS MD

[XGamalieL]

@alexrowland God made human. He created Penis and vagina for PURPOSE.

[manutdforevar]

did you perform this surgery under general anaesthesia?

[NoseMD]

@manutdforevar YES

B. Todd Schaeffer, MD, FACS

[HAVOCKISCOOL]

looks bat what are the big ruff shaped parts. its interesting to se this part of the human boddy good job doc

[tobisha]

looks so painful!..I currently have a bad sinus infection..i hope not to have surgery. Had my wisdom teeth removed which led to the infection. I'd rather have my teeth back in than go thru this infection anylonger.

[lovegreek]

@tobisha Hi! Are you saying having teeth would prevent the infection? How would it lead to infection without teeth? I have my wisdom teeth out and suffer sinus too.

thank you.

[chaudhary2ram]

yeah good job..

[StrengthFromAbove83]

how does one know if they have this fungus? This is so interesting.

[valleyjulie]

... and that is why YOU'RE the doctor and I'm not! lol thanks

[valleyjulie]

I am wondering why you removed so much tissue and bone to the right of the sinus where the fungus was. Was this necessary and why?

[NoseMD]

Dear Valley: This is the ethmoid sinus bullae. It was diseased with chronic sinusitis and blocking the maxillary out flow tract. This enables better maxillary sinus drainage if infected.

BTS MD

[NoseMD]

The video is edited. The procedure took under an hour. She had no symptoms of sinusitis. No headache, pressure drip, smell or taste disturbance. She only noted blood tinged mucous for over a year and had seen several doctors but couldn't help her. Her blood tinged mucous has resolved.

BTSMD

[goddess131]

Hi,

thank you so much for this video, it was very educational.

Were you able to remove all the concretions in this time period (the 6 min time of the video) or did you edit this video? Also, I am surprised the pt did not have any other symptoms other than blood tinged nasal drainage (for a yr right) no HA?, no sinus pain with palpation? No sinus pain or feelings of fullness? And no other allergy symptoms?

thanks

[maurpine]

nice! good to know there's hope for treatment.

[matthew212]

Good job, doctor!