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What can I do?

I have been going to the doctor for several years for sinusitis, then I began to have facial pain.  After several different doctors, I was told that I had trigeminal neuralgia as well as a deviated septum.  I eventually had laser surgery for the trigeminal neuralgia, but the a facial pain continues.  The nerve pain has subsided, but I continue to have facial pain on my left side.  The pain seems to get worse if I lean my head to that side.  This occurred a few years ago, and after several months of taking seizure medication and lortab, I was not getting any better.  Eventually an ENT gave me several different antibiotics and the pain went away for several years. I can't seem to get my doctors to concentrate on the deviated septum because they keep harping on trigeminal neuralgia.  I can hear my sinuses draining and the pain is in my gums and teeth.  What antibiotics will help me so that I can find some kind of relief untill I can possibly have the surgery for the deviated septum?  I have been using a saline spray that seems to help a little.  I have also been experiencing extreme dry mouth, so I need something that will not make this worse.  Thank you.
2 Responses
242588 tn?1224275300
MEDICAL PROFESSIONAL
Trigeminal neuralgia is quite uncommon in people with paranasal sinusitis.  Despite what is commonly believed, facial pain is unlikely to be caused by sinus disease, especially in the absence of any nasal symptoms or signs.  Yet the history of long standing relief of pain following antibiotic therapy prescribed by the ENT for sinusitis must not be ignored.  Thus, while possible, it is unlikely that sinusitis is the cause of your pain and the same can probably be said of your deviated nasal septum.

Trigeminal neuralgia can come and go but your statement suggests that you probably had some type of nasal surgery or what is called percutaneous stereotactic radiofrequency rhizotomy, an effective treatment for trigeminal neuralgia and one with lasting benefit.  Thus the pain that you are now experiencing is unlikely to be related to the trigeminal neuralgia, as you yourself suggest.  Having said that, it is now widely believed that neurologic causes are responsible for a large proportion of headache and/or facial pain.

One seldom suspected neurologic cause of facial pain and occipital headaches is, oddly enough, compression by adjacent muscle or other disease of a bundle of nerves called the brachial plexus, located adjacent to the upper chest.

Pain can be referred to the gums and teeth from other parts of the face but, more commonly, facial pain is due to disease of gums or teeth.

The best way to put to rest the issue of whether trigeminal neuralgia, or any of a number of sites of nerve compression, is playing a role in your facial pain is to consult with a good neurologist.  Many neurologists work with pain clinics and the neurologist may be able to suggest other approaches to chronic pain, even when the cause is not readily apparent.

Good luck.
212161 tn?1537898045
so sorry your going throught that .   to i have bad sinuses can i ask you do you ever wheeze with yours, i got a really bad cold and they say it turn to asthma but my sinuse are really infected had a ct scan and now on 21 days of meds but , not sure i have asthma , wondering with them being so bad could it just be sinuses.  i get the headacks to but have nothad the face pain , but have had like tooth pain when it was my sinus. hope you get better real soon and get the answer your looking for. Barbara
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