Question 1

My CT came back normal but I still feel completely blocked - how is that possible?

Accepted Answer

A normal CT is genuinely useful information - it tells Dr Simon Braham that the sinuses themselves are not the primary source of the problem and redirects the investigation accordingly. Conditions that produce identical sinus symptoms without abnormal CT findings include primary allergic rhinitis, vasomotor rhinitis, nasal valve collapse, migraine presenting as facial pressure, or a functional breathing pattern disorder. A normal scan sharpens the diagnostic focus and points toward the investigations most likely to find the actual answer.

Question 2

If I use a nasal spray or decongestant before the scan, will it change what the CT shows?

Accepted Answer

Regular intranasal steroid sprays can reduce mucosal thickening before a scan and may mean the CT slightly underrepresents peak disease severity. A decongestant taken shortly beforehand can temporarily shrink the mucosal lining. Neither prevents a useful scan - bony anatomy, structural variants, polyps, and retained secretions remain clearly visible - but it is worth mentioning your current medications to Dr Simon Braham so findings can be interpreted in context.

Question 3

I have had sinus symptoms for years and tried everything - is there a point where a CT stops being useful?

Accepted Answer

CT becomes more important, not less, as the history of sinus disease lengthens. In patients who have had previous sinus surgery, an up-to-date CT is essential for assessing whether prior surgical cavities remain patent, whether polyps have recurred, and whether any anatomical factors were not fully addressed at the original procedure. Revision sinus surgery is technically more demanding than primary FESS and is impossible to plan safely without current detailed imaging.

Question 4

Can the CT show whether my sinuses are actually causing my headaches, or could something else be responsible?

Accepted Answer

CT can confirm or exclude significant sinus disease as a structural contributor to facial pain. When the sinuses appear clear, it provides strong evidence that sinusitis is not the source - and redirects the assessment toward other causes including migraine, tension headache, or trigeminal neuralgia. Research consistently shows that a significant proportion of patients self-diagnosed or diagnosed by a GP with sinus headache are actually experiencing migraine, which can produce facial pressure and nasal congestion almost indistinguishable from sinusitis. Identifying this on the basis of a normal CT can be a genuinely transformative moment in a patient's diagnostic journey.

Question 5

My symptoms are always on one side only - does that change what the CT is looking for?

Accepted Answer

Consistently unilateral sinonasal symptoms are taken seriously and investigated with particular care at Melbourne ENT. While a straightforward structural explanation is most common - a deviated septum, a unilateral concha bullosa, or a dental source of infection in the adjacent maxillary sinus - unilateral symptoms can also be the presenting pattern of a sinonasal tumour at an early stage. For this reason, consistently one-sided symptoms should always prompt CT regardless of how long they have been present or how clinically benign they appear.

Question 6

Will the CT show whether I am likely to need surgery again after a previous FESS?

Accepted Answer

CT after previous sinus surgery provides a detailed picture of the current state of the modified anatomy - whether surgical drainage pathways remain open, whether scarring has re-narrowed previously opened passages, and whether polyps have recurred. What CT cannot reliably predict is the precise biological risk of future recurrence, as this depends on underlying inflammatory factors including allergy, eosinophilic disease burden, and the effectiveness of ongoing medical management. CT provides the current anatomical picture; that picture, combined with clinical assessment, guides the most informed recommendation about next steps.

Question 7

Is there anything a CT scan cannot tell my surgeon that still affects the outcome of my surgery?

Accepted Answer

CT provides the essential anatomical foundation for surgical planning but does not capture every dimension relevant to surgical outcomes. The health and healing capacity of the mucosal lining at a cellular level, the degree of eosinophilic or allergic inflammation driving polyp formation, the presence of aspirin-exacerbated respiratory disease, and the patient's adherence to post-operative irrigation and medical therapy are all factors that significantly influence long-term results and are assessed through clinical history, blood tests, and tissue pathology rather than imaging. Dr Simon Braham integrates all of these alongside CT findings to build the most complete picture possible for each individual patient.

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