small sinus cyst

[LH707]

Help...years ago I had a large sinus cyst in my left max. sinus.  I had it removed and felt great for 2.5 years.  Then out of nowhere fatigue hit; for some reason I got antibiotics (its been years now so can't remember exactly what the original symptoms were.) After a zpak, I'd feel great for 2 mos.  Then I'd get hit with aches, pains fatigue, AND swelling in my sinuses.

Fast forward to the last year.  I've had a sensitive spot in my left sinus; facial pain, tooth ache, swelling, extremely watery eyes; I can actually feel something in there.  And I get mild to intense sinus headaches.  I generally don't feel well.  Being on antibiotics helps some, enough for me to get going throughout my day.

The doc won't send me for a CT scan because I had one in 2008 & 2009??? Too much radiation? So and ENT did a scope up my nose, NO infection present and he says I DO have a cyst, but its small and isn't causing my symptoms nor does he recommend taking it out.

I'm at a loss, the Docs don't want to treat me because they don't know what it is.  All I know is that I feel awful; it seems related to my sinuses.

Help!

[David Tinkelman, M.D.]

Your doctor’s reluctance to order another Sinus CT is reasonable.  It is reasonable to assume that your fairly severe symptoms are a reflection of serious disease, as yet undiagnosed.

The problem could be in your sinus and not visible to the ENT who did the “scoping”.  This in turn, could be disease within the sinus or in one or more teeth adjacent to it.  Dental abscess can present in this fashion as can a form of Migraine headache.  In addition, disease involving the Trigeminal (cranial) nerve at its origin can also cause significant facial pain.

With the severity of your symptoms somewhat but not completely relieved by antibiotic therapy, it remains important to try to “pin-down” the cause and treat it.

I suggest that further testing for infection be done, including nasal culture and a White Blood Count and that you and your doctors consider the advisability of seeking a 2nd opinion.

Good luck

[LH707]

Thank you so much for your response.  Had a full dental xray no bad teeth.

I do get cluster headaches from time to time.  But this feeling/illness is not that. As they come, then they go.

I am seeing my ENT today. I will ask for sinus culture and blood work and second opinion.

The not knowing and mild discomfort in my face kept me from work today and is giving me anxiety as I just don't know quite whats wrong.

Thank you again.