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Total Health

Bone Spur in Nasal Sinus

By:
Douglas Hoffman

Question :

I have had chronic sinusitis and allergies for several years now. I started allergy injections four years ago, but I still get two to three sinus infections every six weeks. I was sent for a CT of my sinuses to see if I had polyps. The CT showed I had a bone spur in my left nasal cavity. My doctor and I have never heard of such a thing. I have an appointment to see an ENT soon, but what can you tell me about this condition?

Buster

Answer :

Before I launch into a long explanation of bone spurs, I want to state, very clearly, that your nasal problems are almost certainly UNRELATED to the spur. Spurs may occasionally cause nosebleeds or nasal-airway obstruction, but it would be extraordinary for a spur to cause recurrent sinus infections.
I am going to explain what is usually meant by a bone spur. Since I have not seen your CT scan, I cannot be absolutely positive that the explanation I'm about to give is accurate for your case. I suggest you copy this letter and bring it with you when you visit the ear, nose and throat specialist (ENT). Ideally, he or she will review the CT with you and show you what the radiologist has called a spur. Show the ENT this letter, and ask, "So is this what Dr. Hoffman was talking about, or do I have something else entirely?"

Here are the relevant bits of anatomy. Close to the floor of the nose, the septum (the "divider" that separates the nose into two nasal cavities) is made up of cartilage. The nasal floor itself is made up of bone. There is a bony ridge running down the middle of the floor (called the "maxillary crest") that joins the lower part of the nasal septum. The cartilaginous septum and the bony maxillary crest both "flare" or bulge in the area where the two join. If you are still a bit disoriented, put your finger up your nose. Go on, do it. Nobody's watching. Now touch your septum. The area you are touching is the area I am talking about. In some people, the septum has "slipped off" the maxillary crest, and in other people, the crest itself may have a very irregular shape. Spurs may occur along this area.


As noted above, spurs can cause occasional nosebleeds (turbulent airflow leads to mucous-membrane chapping) and can also contribute to nasal-airway obstruction, but I have a hard time understanding how a spur can cause sinusitis. This is assuming, of course, that what I have illustrated for you here is, indeed, "your" bone spur. Which brings me back full circle. TALK TO YOUR ENT! The fact that you have suffered for several years with recurrent bouts of sinusitis indicates, quite plainly, that SOMETHING is wrong. Perhaps you do have an anatomical problem in your sinuses predisposing you to sinusitis (which should be evident on the CT). Perhaps you have an intrinsic problem with your health, such as a weakness in your immune system. Or perhaps you have just been inexpertly treated for your recurrent infections. It is also possible that your allergies are to blame, yet your allergy therapy is off-target. Your ENT will "play detective" to determine why you have been troubled with this problem for so many years.

 

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