Sinus CT Scan Before Nose Surgery

Dr Kleid often orders a CT scan of the sinuses to assess sinus and nose problems before surgery. This is because it helps visualize the upper airway and pinpoint the abnormality.

Our upper airway is more complex than you think. The nose is connected to a series of hollow, air-filled cavities called paranasal sinuses. They perform various functions, like moisturizing the air you breathe.

As you breathe in, your sinuses also absorb certain substances, making you vulnerable to infections, inflammations, and allergies. These can later progress into chronic nasal and sinus conditions, particularly sinusitis, that may need surgical intervention.

Computed Tomography (CT) is one of the most reliable imaging techniques used by ENT surgeons. This is because it gives us a closer look at what’s happening in and around your sinuses to determine the best surgical procedure.

To learn more about how a CT scan can set you on the right road to relief, let’s talk about how it works and how it can benefit your treatment.

What Is a Sinus CT Scan?

Imagine an apple. From the outside, you can only see so much. But when you slice it into thin cross-sectional slices, you can see the different depths and how the structures extend throughout the fruit.

Computed Tomography (CT), also called a CAT scan, of the sinuses has the same principle.

A CT scan is carried out by X-ray technology to create images in multiple planes and even three-dimensional images that help us better understand ENT problems affecting your sinuses.

CT of the sinuses is both painless and non-invasive. Contrast injections are not required. The scan may reveal important internal structures like surrounding soft tissues, nasal septum, blood vessels, and paranasal sinuses in greater detail than other imaging tests.

This also allows Dr Kleid to assess the different sinus groups:

  • Frontal sinuses (in the forehead),
  • Maxillary sinuses (inside cheekbones)
  • Ethmoid sinuses (either side of your nose, near the eye sockets)
  • Sphenoid sinuses (deep inside your nose, 7 cm from the nostrils).

It’s the most accurate and reliable imaging technique for determining the diagnosis and the best mode of treatment for various ENT conditions. Furthermore, it can help locate obstruction, inflammation, or anatomical abnormalities of the upper airway.

Somewhat surprisingly, CT is not very good at assessing some septal deviations.

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What is Nasendoscopy?

Depending on the patient’s symptoms, and the nasendoscope findings, Dr Kleid might also request a CT scan of the sinuses. The primary role of a sinus CT scan is to aid in both the diagnosis and management of various acute and chronic ENT medical conditions, in particular Chronic sinusitis.

Before your nose surgery, pre-surgical planning tools like a sinus CT scan might help the decisions we make.

This way, we can decide on the best manner to carry out safe surgical procedures while preventing complications.

As an experienced otolaryngologist, Dr Kleid uses a sinus CT scan to assess any obstructions or changes that would not be seen otherwise, even with nasendoscopy.

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Is a Sinus CT Scan necessary before Nose Surgery?

The primary role of a sinus CT scan is to aid in the diagnosis and management of various acute and chronic ENT medical conditions. Before your nose surgery, presurgical planning tools like a sinus CT scan guide the decisions we make.

Substantial evidence in not only practice but also research support sinus CT scan as the gold standard imaging study before nose surgeries. It allows us to examine the structures of the nasal sinuses that may be directly affected.

As an experienced otolaryngologist, Dr Kleid uses a sinus CT scan to assess any obstructions or changes that would not be seen otherwise.

So, although it isn’t absolutely necessary, we recommend a sinus CT scan to help us determine the extent of your condition. This way, we can decide on the best manner to carry out safe surgical procedures while preventing complications.

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Why would an ENT Surgeon request a CT Scan?

A sinus CT helps create a clearer, more detailed picture of your paranasal sinuses and the neighboring structures for Dr Kleid to accurately assess any injury, infection, or other airway abnormalities.

We may request a sinus CT scan to look for diseases affecting the sinuses, identify the cause of your nasal or sinus symptoms, and plan for the appropriate surgical technique. Thus, a sinus CT can diagnose or confirm various conditions of the nasal cavity and sinuses.

Let’s look at some of the common nasal conditions that we manage with the help of a sinus CAT scan.

Rhinitis

Rhinitis is an upper respiratory airway infection. Either a common cold or seasonal allergy (allergic rhinitis) can lead to inflammation and swelling of the lining of your nasal cavity.

If you have rhinitis, you may experience:

  • Runny nose
  • Stuffy or congested nose
  • Temporary loss of your sense of smell

CT scan is not usually needed to diagnose or treat rhinitis. However, if the symptoms persist for a long time, and Dr Kleid suspects an underlying pathology, a sinus CT might help.

Acute Sinusitis

Acute Sinusitis is a short-term (lass than 6 weeks) inflammation of your sinuses, usually signifying infection. The swelling of your sinuses causes a build-up of mucus, which then interferes with your normal sinus drainage and ventilation, leading to a stuffy nose.

Symptoms of sinusitis often include:

  • Nasal obstruction
  • Nasal discharge
  • Facial discomfort, or pain
  • Fever
  • Malaise, weakness

Several factors can inflame or irritate your nasal passages and sinuses, such as allergies, environmental pollutants, or sinus infections (bacterial sinusitis or fungal sinusitis).

Treating chronic sinusitis may involve medication for your allergic reaction or antimicrobial therapy.

If surgical intervention is necessary, Dr Kleid may perform either a functional endoscopic sinus surgery or balloon sinuplasty to remove the obstruction and promote drainage.

Chronic Rhinosinusitis

Chronic rhinosinusitis is an inflammatory disease of your nasal cavities and paranasal sinuses.

It is not an infection, but a disease of mucus retention and abnormal drainage. It can become infected, or just contaminated by bacteria, or fungi. The inflammation causes swelling in the sinus lining (mucosal swelling), and even large swellings called “polyps”.

It’s defined by at least 2 of the 4 cardinal symptoms for at least 12 consecutive weeks:

  1. Facial pain/pressure
  2. Hyposmia/anosmia (reduced sense of smell)
  3. Nasal obstruction
  4. Nasal drainage, especially post-nasal drip (also called “catarrh”.
  5. Patients also often feel quite tired.

Treatment aims to improve muco-ciliary clearance (mucous drainage). We often use nasal irrigation to clear your nasal passages or intranasal corticosteroid sprays to reduce inflammation.

Dr Kleid may also perform endoscopic sinus surgery, at the time of Septoplasty, or Septo-Rhinoplasty.

With the help of an endoscope, a small lighted camera, he can view and surgically enlarge your paranasal sinuses for better ventilation and drainage.

Nasal Polyps

Nasal polyps are non-painful and non-cancerous mucosal swellings in the lining of either the nose or sinuses. They look and are juicy, with a “stalk”, like grapes. They can be single, or multiple. These growths are more common in patients with asthma, allergies, or repeated infections in your nasal passages. Chronic rhinosinusitis and allergic rhinitis are often associated with nasal polyps.

If a nasal polyp enlarges, it may cause obstruction and subsequently:

  • Headaches
  • Nosebleeds
  • Nasal congestion, stuffy nose
  • Runny nose

Larger nasal polyps may be severe enough to interrupt your breathing during sleep (sleep apnea) and cause snoring.

Typically, we prescribe corticosteroids to shrink the polyps. If non-operative measures don’t work, or only help temporarily, Dr. Kleid can do endoscopic sinus surgery to remove your nasal polyps and enlarge the drain holes to the sinuses.

How is a Sinus CT Scan performed?

You will be given a hospital gown to wear before the procedure. You will need to remove all metallic items from your body, such as jewellery, hairpins, and eyeglasses, which block the X-rays.

The CT machine is shaped like a large vertical donut, with a table that slides in and out of the tunnel at its middle.

The radiology technician will position you on the examination table, usually lying on your back or face-down with your chin elevated.

The exam table will move slowly through the CT scanner’s tunnel, the machine may make several passes before your scan is complete.

Contrast injections are not required for sinus CT scans.

The entire process takes around 10 minutes. You get high-quality, 2D- and even 3Dimensional, cross-sectional images of your body that a radiologist can interpret and report to Dr. Kleid.

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What can a Sinus CT Scan reveal?

A CT scan of your sinuses creates a cross-sectional view of internal structures that we could not assess with physical examination alone.

On a CT scan, your nasal bones appear white. Your soft tissues show up in shades of grey. And your normal, healthy air-filled sinuses should appear black. A sinus CT scan that shows abnormalities in these structures can reveal a sinus or nasal health condition.

To help you understand better, here are a few sinus conditions that can be diagnosed with information from a sinus CT scan.

  • Congested sinuses: A CT of the sinuses is the gold standard test for determining the extent of both chronic sinusitis and chronic rhinosinusitis. If you have chronic rhinosinusitis, your scan can show opaque, instead of normally black, sinuses. This means that the sinuses are filled with fluid and debris rather than air.
  • Abnormal growths: Polyps typically appear as small, grey, teardrop-shaped growths on the lining of your nasal passages or sinus cavities. But on a CT scan of your sinuses, they appear like cloudy spots.
  • Carcinoma: A CT scan of your sinuses may reveal nasal cavity or paranasal sinus cancer. Tumours of sinuses are extremely rare.
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Risks of a Sinus CT Scan

The CT sinus scan is a painless and safe diagnostic procedure. But as with any medical procedure, there are some risks involved.

  • Small dose of radiation exposure potential harm to unborn babies (if you are pregnant)

At your consultation, we go over your medical history before recommending a CT scan to make sure you are a suitable candidate and avoid any complications. Dr Kleid ensures the safety of all his patients by weighing the risks and benefits of a sinus CT scan for correct diagnosis.

Cost-of-ENT Surgery

How much does a Sinus CT Scan Cost?

For patients in Australia, sinus CT scans and other diagnostic ENT imaging tests are usually mostly covered by Medicare and most major insurance providers.

A sinus CT is usually considered a medical necessity in certain ENT conditions, like chronic sinusitis. It is important to diagnose upper airway abnormalities and plan the surgery. Therefore, sinus scans are usually eligible for rebates.

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Is MRI or CT Scan better for Sinuses?

Diagnostic imaging techniques have advanced a lot over the years and have enhanced our understanding and management of sinus conditions.

We now have various radiological tests, including Magnetic Resonance Imaging (MRI) and CT scan, to help with diagnosis and treatment. However, choosing the right imaging test depends on many factors.

When it comes to sinus surgery, a CT scan is the test of choice. It provides more detailed information about the anatomy of your paranasal sinuses. It is more reliable, more sensitive, and shows sinus abnormalities in greater definition.

Here are some benefits that make a sinus CT scan the preferred diagnostic procedure before nose and sinus surgery:

  • Less expensive
  • Faster procedure and results
  • Detailed images of nasal bones and tissues
  • Less risk of false-positive findings

Generally, MRIs are only used for assessing sinus tumours.

FAQs

References


Why Choose Dr Kleid for Rhinoplasty?

Dr Stephen Kleid
Cosmetic Rhinoplasty
Melbourne

Dr Stephen Kleid is an experienced ENT Surgeon (Otolaryngologist) based in Melbourne with a passion for Septo-rhinoplasty, Septoplasty and a strong interest in Rhinoplasty Revision.

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What to Bring to Your Consultation

  • If you like, please bring a friend or relative to help discuss the information and your choices.
  • Take a lot of notes and thoroughly examine the documents your surgeon provides.

How to Book a Consultation

  • Dr Kleids Consultation fee is $600 which includes a nasendoscopy ($300).
  • A referral from your Doctor is helpful to claim any Medicare or Health Insurance rebate but is not necessary for a consult.
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