--over the years; in fact, my most recent CT scan of the area, back in December 2015, is not all that different from yours, with the varied mucosal thickening, evidence of inflammation, and even the deviation of the septum. Of course, it's probably worth mentioning that my nose has been broken, in various athletic pursuits, on 4 different occasions over my late teens and twenties. (All I ask is that it points in the right direction.)

I too have tried various medication rounds--sprays, pills, antibiotics when things are bad, which do help at least temporarily, if not permanently. My CT scan does say that the configuration up there DOES predispose to likely repeated bouts of sinusitis, but my ENT is much slower with the knife, apparently, than yours is--he says he would only recommend surgery if I couldn't breathe or couldn't clear up intermittent exacerbations.

In the meantime, the most effective day to day help has been the good old neti pot with warm saline water, which I try to do religiously and more often during allergy season (which is getting longer and longer with climate change). But I admit that it's a process that is ongoing and imperfect--my sinus problems are relapsing and remitting in nature, and never completely gone.