Image Guided Surgery – Polyps = Smelling

 

Here's what I wrote on November 11, 2003 (about 1 month after my surgery):

Greetings fellow anosmics,

For those of you whose anosmia is caused by polyps and are considering surgery (for the first, second, etc., time), I'd just like to urge you to explore all surgical options.  I recently had surgery at the Massachusetts Eye & Ear Hospital where the doctor (Ralph Metson, MD) used image guided surgery.  It's a fairly new technique which seems not to be available in the typical small to medium hospital.  The major advantage is that the surgeon can be far more aggressive while being more certain that he will not damage the optic nerve or other important structures.  In the typical surgery, the surgeon can clean out the ethmoid and maxillary sinuses fairly well, but cannot get into the frontal sinuses or sphenoid sinuses.  With image guided surgery the surgeon can clean out the frontals, sphenoids and better clean out the ethmoids.  This works because the instrument’s position is shown on a computer screen superimposed on your CT scan.  Prior to the image guided surgery, I would only smell very occasionally or while on Prednisone.  Since the surgery (about a month ago), I've been smelling as well as ever.  (I didn't smell for the first 5 or 6 days after the surgery due to the crap & crud that was stuck in there post surgery, but since that cleared, I've been smelling about 99% of the time.)   If you've had surgery, you realize that you're going to feel fairly crappy (mostly from the anesthesia) for a few days so you might as well have the surgery be as modern and aggressive as safely possible.

Here's what I wrote on December 6 of 2004:

I had had 2 polyp surgeries which "lasted" for several months with the more conventional type of surgery (often called FESS - functional endoscopic sinus surgery), but without any sort of image guided surgical techniques.  For my last surgery (about 13 months ago now), I had image guided surgery.  Since that time I've been smelling 99.999% of the time.  My maintenance is daily irrigation with a NasalRinse bottle and once per day use of Nasarel (a steroid spray) along with occasional use of Allegra and Sudafed depending on the allergies of the day.

And, as of 4/5/2005 (about 18 months post-surgery):

I still smell effectively 99.999% of the time.  As I'd mentioned in some other emails, I smell perfectly out of the right nostril 99.999% of the time.  The left nostril never smells anything.  I have no recollection whether I ever could smell out of the left.  However, unlike being blind in one eye and losing stereoscopic vision, there is no perceptible difference in smell between the two nostrils so that is why I say I effectively smell 99.999% of the time.

And, as of today (3/31/2006) (almost 2 and 1/2 years post-surgery):

Same as above (4/5/2005) except I had a very brief period of smelling (2 days) on the left side shortly after starting a high-blood pressure medication (Toprol XL) - I'm putting this down to a coincidence.  However, it has made me realize that the olfactory bulbs are intact on both sides.

Daily Routine

• Daily Nasal irrigation with NeilMed Sinus Rinse using 1/2 t. NaCl and warm tap water.  Others prefer the packets sold by NeilMed and distilled water.  I believe irrigation is absolutely critical to keeping things clear and it has the added benefit of grossing out little kids.

• Daily use of Nasarel (steroid nasal spray) - 1 squirt each side.

• Occasional use of Allegra (now Fexofenadine) allergy pill - taken when symptoms require.

• Occasional use of Sudafed - taken when symptoms require.

• Monthly Allergy Shots (aka Immunotherapy) for molds, pollen, dust and various other allergens.

 

Best of luck to you.   Feel free to contact me with any questions.

                                        Michael Russell
                                        russell@mathtech.com