those holes in my head

This is a picture of my face from the front.  You know, if you had CT-vision and were looking at me head-on this is what you would see.  I will explain some of what you are seeing.

The two big black holes in the middle are my maxillary sinuses.  You can see pointing to these sinuses a green captain saying "pus (yay!)".  The pus is from inflammation in my sinuses & nose and mucus not being able to drain.  My understanding is that the mucus turns into pus under these conditions.  (Don't take my word as law.)

Do you see the green captain that says "more pus?" ?  The arrows are pointing to my ethmoid sinuses.  I'm wondering if the gray splotches (not the lines- those are just dividing walls between sinuses) are pus, too.

Ah, "deviated septum".  That is one of the key features in this CT.  Notice the dotted line marked "A" by the radiologist?  That's the line my septum (the white line the green arrow points to) should follow, but doesn't.  Thus why my septum is called a deviated one.  See the blue circled part labeled "bad"?  I believe that is where my Dr said the septum is making contact with the bone or the turbinates or something.  Anyways, it's not supposed to happen and when it does it can cause pain along the trigeminal nerve pathway.

Which brings us to the trigeminal nerve.  I drew it for you since it doesn't show up on CTs.  As you can see, the trigeminal nerve has 3 major branches- one to the temples/sides of the forehead, one to the nasal area, and one to the jaw.  This nerve is a major player in migraine headaches and you can see why sinus or jaw problems might cause migraines, or why a migraine may involve facial pain and/or jaw stiffness.  This is because if something painful happens at one branch of the trigeminal nerve, the pain messages can get sent all along the other branches.  Youch!  This is the reason why my Dr thinks my sinus problems might be the problem that is sending my migraines and headaches over the top.

One last note, look at the yellow arrows labeled "R&L nasal passages".  You can see how the L nasal passage is half the size of the R one.  This is the reason why my mucus can't drain and also the reason why I get short of breath more easily when I'm breathing through my L nostril.

The abnormal size of my L nasal passage, plus all the collected mucus/pus in my sinuses aggravates my asthma and sleep apnea.  Since this picture (CT scan) was taken, I believe the pus in my R maxillary sinus has decreased... I wouldn't be surprised if it had disappeared.  This is because the magic Dr treated me for sinus infection and the R side of my face can actually drain, whereas the L still has problems.

I will note an interesting Cassanndre-Sinus-Migraine factoid: I can tell if a particular migraine is triggered by sinus problems because the pain is localized to the L side of my head (the side to which my septum deviates).

Fascinating, eh?

For a real lesson on sinus anatomy, see the American Rhinologic Society here.


UPDATE:  on account of the crazy snow storm which hit the seattle area, my surgery on the 19th was cancelled.  it is now scheduled for weds, feb 1st.  :)