Ste9
05-09-2007, 09:21 PM
I just got back from Makkiah's ENT appt. It took 4 hours!
Makkiah has dealt with chronic sinus issues for years. He's maxed out on allergy meds. We went and saw the allergist a while ago and his work up was unremarkable. He had an allergy to dog and dustmites but not severe. When we put him on antibiotics it works until we stop them. Well after months of horrible sinus drainage the pulmonologist put him on antibiotics and sent him for a CT scan. He was not having any drainage when he had the CT scan done. The pulm sent a consult to the peds ENT who we have seen many times before.
So I thought we would be going in and getting his sinus cleaned out and then we would be on our merry way. Boy was I wrong.
First off Makkiah never developed the sinuses above his eyes probably due to them being blocked. The dr said that usually they aren't big enough to cause serious problems in kids Mak's age but Mak has none.
The left sinus below his eye is totally normal but the sinus on the right side is not. It is completely impacted and the ENT said he thinks there is an anatomical anamoly that is keeping it from draining. He thinks there is no opening between the sinus and his nasal passage. So he is have a FESS (Functional Endoscopic Sinus Surgery) with anterior ethmoidectomy and maxillary antrotomy. Basically they will go in and chip the bone away to create holes in his sinus so they can drain. This carries serious risk since they are so close to his eye orbit and his brain. But without the surgery they are concerned that the infection will start to eat away the bone in his face.
Due to his history with airway issues he is at increased risk for airway issues. I was told that usually they use a "cuff" for the airway during the procedure but they will intubate him as they are concerned with securing his airway. Intubating him for such a long procedure (we are looking at 1 hour minimum)carries additional risk with swelling in his airway as his airway is smaller than most. Since they can't use albuterol with him as a rescue med there is increased concern. They will give him steroids during the procedure to help decrease the swelling.
Makkiah has dealt with chronic sinus issues for years. He's maxed out on allergy meds. We went and saw the allergist a while ago and his work up was unremarkable. He had an allergy to dog and dustmites but not severe. When we put him on antibiotics it works until we stop them. Well after months of horrible sinus drainage the pulmonologist put him on antibiotics and sent him for a CT scan. He was not having any drainage when he had the CT scan done. The pulm sent a consult to the peds ENT who we have seen many times before.
So I thought we would be going in and getting his sinus cleaned out and then we would be on our merry way. Boy was I wrong.
First off Makkiah never developed the sinuses above his eyes probably due to them being blocked. The dr said that usually they aren't big enough to cause serious problems in kids Mak's age but Mak has none.
The left sinus below his eye is totally normal but the sinus on the right side is not. It is completely impacted and the ENT said he thinks there is an anatomical anamoly that is keeping it from draining. He thinks there is no opening between the sinus and his nasal passage. So he is have a FESS (Functional Endoscopic Sinus Surgery) with anterior ethmoidectomy and maxillary antrotomy. Basically they will go in and chip the bone away to create holes in his sinus so they can drain. This carries serious risk since they are so close to his eye orbit and his brain. But without the surgery they are concerned that the infection will start to eat away the bone in his face.
Due to his history with airway issues he is at increased risk for airway issues. I was told that usually they use a "cuff" for the airway during the procedure but they will intubate him as they are concerned with securing his airway. Intubating him for such a long procedure (we are looking at 1 hour minimum)carries additional risk with swelling in his airway as his airway is smaller than most. Since they can't use albuterol with him as a rescue med there is increased concern. They will give him steroids during the procedure to help decrease the swelling.