seeking ENT advice! ❤️‍🩹

I’ve struggled with chronic rhinosinusitis my whole life alongside allergies.

Last year, I underwent rhinoplasty hoping that it would resolve my breathing issues and an aesthetic issue caused by my deviated septum.

I’m well over a year post-op and I am unable to breathe most days, despite nasal steroid use, allergy medicine, frequent saline treatments.

I can only breathe out of my mouth well enough. My nasal passageways feel significantly smaller, and my left nostril is noticeably difficult to breathe out of and makes a flapping/wheezing sound.

My inability to breathe also makes me prone to being fatigued, foggy brained, and I am genuinely concerned that this will have incredibly negative effects on my overall wellbeing and functioning.

I’ve gone to an ENT to mitigate this issue so far, and have CT scans this week for a closer look. Important info from my last visit:

Nasal cavity: The septum is mildly deviated; to the right; mid-septum. Clear, thick mucus in bilateral nasal cavities. Inferior turbinates: Moderately hypertrophied. Middle turbinates and middle meatus: healthy appearing, no polyps, lesions or drainage Superior turbinates and spheno-ethmoid recess: healthy appearing, no polyps, lesions or drainage Nasopharynx: Clear Imaging: The radiographic reports available today were reviewed. CT Maxillofacial 12/4/21 (report only) Findings: There is no acute facial fracture. Mandibular condyles are normally located. There is mild mucosal thickening in the maxillary sinuses with trace air-fluid levels posteriorly. There are mucous retention cysts in the inferior maxillary sinuses and in the anterior right sphenoid sinus. Moderate multifocal mucosal thickening in the ethmoid air cells bilaterally. The mastoid air cells and middle ear cavities are clear. There is rightward deviation of the nasal septum. Multifocal mucosal thickening in the superior nasal cavity. Orbital structures are normal. No preseptal inflammation. No retrobulbar hematoma. No suspicious osseous lesions.

Impression: 1. Possible chronic rhinosinusitis 2. Bilateral inferior turbinate hypertrophy 3. Nasal septal deviation 4. Environmental allergies 30 year old adult with likely chronic rhinosinusitis. Also has probable allergic rhinitis. Will start appropriate medical therapy and evaluate response to treatment.

So now to my question: What is the likelihood based on the info above that it will be deemed medically necessary for me to have another nasal surgery like a septoplasty? In addition, I’ll most likely ask for a change in my nose tip as it’s not proportional to the rest of my face and I am willing to pay out of pocket for that.)

If I don’t qualify for a septoplasty, I’m going to seek revision with an ENT in Mexico instead where I can afford it.

submitted by /u/cyberruca
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