Patient age 45+ have feel sob and closing of nostrils ...no lung patha

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Patient age 45+ have feel sob and closing of nostrils ...no lung pathalogy...just not take proper breathing through nose...doctor suggestion CT scan of nasal cavity ...can you find out the result pathalogy if I send you CT film

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I have now carefully reviewed all three CT film photographs and the relevant otolaryngology textbook content. Here is my detailed educational analysis:

⚠️ IMPORTANT MEDICAL DISCLAIMER

I am an AI, not a licensed radiologist. This analysis is for educational purposes only and does NOT constitute a formal radiological report. The patient's treating doctor and a qualified radiologist must interpret this scan officially. Do not make any treatment decisions based on this response alone.

CT Paranasal Sinuses - Observational Analysis

What the Images Show

The three photographs show the same CT film from different angles. This appears to be a CT of the paranasal sinuses and nasal cavity, displayed on a single large film sheet with multiple rows of axial and coronal slices. The scan includes:

Top rows: Axial (horizontal) cuts through the nasal cavity, maxillary sinuses, and ethmoid sinuses
Middle rows: Axial cuts at a higher level through the brain/orbits
Lower rows: Coronal (front-facing) cuts through the sinuses - the classic "face-on" sinus view used in ENT

Key Observations (Educational)

1. Nasal Septum Looking at the axial and coronal cuts of the nasal cavity, the nasal septum appears deviated. In the upper axial slices, the septum does not sit precisely at the midline. This is consistent with deviated nasal septum (DNS), which is one of the most common causes of unilateral or bilateral nasal obstruction and difficulty breathing through the nose.

2. Inferior Turbinates The inferior turbinates (the bony scrolls lining the nasal cavity) appear prominent/enlarged in several cuts. Inferior turbinate hypertrophy is a very common finding in patients with chronic nasal congestion, allergic rhinitis, or long-standing DNS (the turbinate on the wider side compensates by enlarging).

3. Paranasal Sinuses

The maxillary sinuses (large paired sinuses below the eyes - visible as dark air-filled spaces in the coronal views) appear to show some degree of mucosal thickening along the floor/walls in at least one side. Normally the sinuses should be completely air-filled (dark/black on CT).
The ethmoid sinuses (multiple small cells between the eyes) are visible and show some haziness in cells on one side, which can represent mild inflammatory disease.
The frontal sinuses (upper rows, above the eyes) appear relatively clear.

4. Brain Parenchyma The brain slices in the middle rows appear normal - no obvious masses, bleeds, or asymmetry visible at this resolution. This is consistent with the history of "no lung pathology" and the focus being on nasal/sinus disease.

5. Concha Bullosa (possible) In some of the coronal cuts, the middle turbinate appears enlarged, raising the possibility of a concha bullosa (air cell within the middle turbinate) - a common anatomical variant that can contribute to nasal blockage.

Likely Findings - Differential Diagnosis Based on Clinical History + CT Appearance

Given: 45+ year old, shortness of breath, nasal closing/obstruction, no lung pathology:

Finding	Likelihood	Significance
Deviated Nasal Septum (DNS)	High	Mechanical nasal obstruction
Inferior Turbinate Hypertrophy	High	Reduces nasal airway passage
Chronic Rhinosinusitis (CRS)	Moderate	Mucosal thickening, sinus opacification
Concha Bullosa	Possible	Anatomical variant causing obstruction
Nasal Polyps	Possible	Soft tissue masses in nasal cavity
Allergic Rhinitis	Possible	Bilateral mucosal swelling

What the ENT Specialist Will Look For Formally

According to Cummings Otolaryngology Head and Neck Surgery and K.J. Lee's Essential Otolaryngology:

Ostiomeatal Unit (OMU) obstruction - the drainage pathway of the sinuses; if blocked, sinusitis follows
Lund-Mackay score - a formal CT scoring system used to grade sinusitis severity (0-24 scale across 12 sinus regions)
Bony changes - thickening/remodeling suggests chronic disease
Air-fluid levels - indicate acute infection

The textbook notes that in CRS: "signs suggestive of CRS include diffuse or polypoid mucosal thickening, partial or complete opacification of the sinuses, bone remodeling and thickening (osteitis), intrasinus calcifications, and polyposis" - Cummings Otolaryngology

Why Nasal Obstruction Causes Shortness of Breath

In a 45+ year old with no lung pathology, nasal obstruction (from DNS/turbinate hypertrophy) forces mouth breathing, reduces nasal CPAP effect during sleep, and can contribute to a sensation of "not getting enough air." The nose normally conditions, filters, and creates resistance that makes breathing feel more effective. Loss of this function creates the SOB sensation.

What Comes Next (Likely Treatment Options)

Depending on the formal radiologist report and ENT evaluation:

Medical management first: Nasal steroid sprays (fluticasone, mometasone), saline irrigation, antihistamines if allergic component
Septoplasty - surgical correction of deviated septum
Turbinate reduction - radiofrequency or surgical reduction of enlarged turbinates
FESS (Functional Endoscopic Sinus Surgery) - if significant sinusitis is confirmed
Concha bullosa resection - if confirmed and contributing

Please ensure the CT scan is formally reported by a licensed radiologist and the findings are reviewed by the attending ENT (otolaryngologist) before any treatment is planned. The observations above are general educational guidance based on what is visible in these photographs of the CT films, with significant limitations in resolution due to the photographic format (as opposed to a direct digital DICOM file).

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