Dr. John Ditto, an ENT Specialist at Richmond Breathe Free Sinus & Allergy Centers, said that patients with treatment-resistant chronic sinusitis require a more detailed diagnostic process, including CT scans, cultures, and review of past surgeries. This statement was made on Instagram.
“Patients have been to other offices who’ve had chronic sinusitis and they still don’t have relief,” said John Ditto, according to Instagram. “Some of it could be incomplete surgery or missing sequence at ostium. Culturing the patient to make sure that the appropriate antibiotic therapy and the appropriate duration has been performed. Sometimes you have to treat them for three weeks.”
According to Science Direct, persistent symptoms in chronic rhinosinusitis (CRS) patients can result from incomplete surgical intervention, particularly when the natural ostium of the maxillary sinus is not properly identified or opened during surgery. This oversight can lead to the “missed ostium sequence,” where the sinus fails to drain effectively, causing ongoing inflammation and infection. Ensuring the natural ostium is addressed during surgery is crucial for successful outcomes.
As reported by the National Library of Medicine, in cases of chronic sinusitis, especially when initial treatments fail, it is important to consider the possibility of incomplete surgery or missed anatomical structures like the sinus ostium. Addressing these issues may require revision surgery to correct anatomical problems and restore proper sinus drainage. Such interventions can significantly improve patient outcomes.
According to UpToDate, culturing the sinus contents can guide appropriate antibiotic therapy in chronic sinusitis patients. This approach ensures that selected antibiotics target specific pathogens present, potentially improving treatment efficacy and reducing the risk of antibiotic resistance. Tailoring antibiotic therapy based on culture results is a recommended practice in managing chronic sinus infections.
According to Richmond Breathe Free’s website, Dr. Ditto earned his medical degree from the University of Missouri-Columbia School of Medicine, where he was recognized for his research. He then received specialized training in ear, nose, and throat disorders at the University of Michigan’s Department of Otolaryngology-Head and Neck Surgery.
Richmond Breathe Free Sinus & Allergy Centers is a medical practice led by Dr. Ditto, a board-certified otolaryngologist and head and neck surgeon. The clinic offers minimally invasive procedures such as balloon sinuplasty to provide lasting relief for patients suffering from chronic sinusitis. The practice emphasizes personalized care plans tailored to individual patient needs, aiming to improve overall quality of life through effective treatment strategies.
