poucho,

How did they determine you have a sinus cuff? I am in a similar situation in that my cuffitis is very bad and not being controlled with meds so I am looking at pouch advancement surgery also. My surgeon did not mention anything about a sinus though. he did say my ulceration was about and 8 to 10 out of 10. I am also trying to avoid this surgery so I am now treating with cortifoam in hopes it may help, but this has been ongoing now for over a year.

After my cuffitis inflammation subsided, Dr.Shen found a sinus. MRI by surgeon and he thinks this sinus has been there since my initial surgery 4 1/2 years ago when i had a leak then. Dr.Shen is trying to fix it via scope and kneedle/knife procedure.Had 2 done and go back for final in a month. He feels if it does not work i need major surgery again. My surgeon does not, and believes to let it alone unless it starts to become an issue as far as abcess.

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He feels if it does not work i need major surgery again. My surgeon does not, and believes to let it alone unless it starts to become an issue as far as abcess.

A sinus is like a fistula that leads to nowhere right? I'm with your surgeon on this one. if it isn't causing any issues, why have major surgery to *try* and fix it? i have heard great things about Dr. Shen, and I know he has helped many patients, but this seems a bit too aggressive in my opinion. my surgeon also feels if my tiny fistula is not bothering me, i should leave it alone. they said is very risky to start messing with it (that could make it bigger, in fact). if Dr. Shen thinks you should have major surgery to correct it, of course major surgery is not without its risks. i appreciate sometimes how doctors like Shen are research-driven and innovative, but it is about risk vs. benefit, and i don't know if there is much benefit in attempting to fix a sinus that is has been there for 4.5 years and not causing any issues. my 2 cents.

Pouchomarx, may I ask who your surgeon is that says to leave it alone?