Question: My husband has had persistent pain after sinus surgery in April 2007. Three days later, he had staph in his sinuses. It took 4 months to treat it. November 2007, he got staph in his sinuses again. This time, it took 5 months (April 2007) to treat it. His ENT says his sinuses now look great, that there is nothing else he can do. Is there a possibility that he has nerve damage from the staph? He hasn’t had any major infections since the last staph. He does have allergies, but we were told they were minor.
He is in constant pain 24/7. He says it is like a deep pain, as if someone is hitting his bone/sinuses with a “pick hammer”. He has been checked for osteomyelitis too, but nothing showed up. The pain is located in every sinus area except the left frontal sinus (he was born without it). We just don’t know where to go next…we are desperate. Any suggestions would be greatly appreciated Thank you!
Answer:
Thank you for writing to us. Unfortunately I can’t give you a diagnosis of your husband’s specific medical problem and can only answer in general. As always, direct medical care is essential.
Constant facial pain after sinus surgery is unusual. There are many different possibililties, including facial pain syndromes, temperomandibular joint problems, and other neurologic pain. There may well be something actually irritating his nasal and sinus mucosa- which should be evaluated if this has not been done. We have had patients with chemical sensitivities causing such a problem, and quite often gastro-esophageal reflux, i.e. stomach acid, that comes as high as the nasal passages and sinuses can cause burning pain. Once problems such as osteomyelitis, tumor, or persistent infection have been ruled out, one should be evaluated for these other issues. He should consider pH testing, either with a probe at the upper part of the food pipe, esophagus, or a newer evaluation (Restech) that measures acidity in the back of the nose.
Robert L. Pincus MD
NY Sinus Center
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