Sinus Infections and Orthognathic / Maxillofacial / Jaw Surgery
As previously discussed in my recovery notes, I started
to suffer from sinus infections from 5 months post orthognathic surgery.
However, I had symptoms from 3 months post-surgery. When I first expressed to
my surgical team I was having pain in my face and I still had visible swelling,
they gave me an x-ray to makes sure the jaws were not infected. The x-ray came
back clear and it was advised that I continue with the anti-inflammatories and rest.
Due to the jaw pain and swelling left
behind from the surgery it took a while before my sinus infections were treated
with antibiotics. I had never experienced a sinus infection before surgery and I
had hoped that this would be a one off. Unfortunately, after I finished my
first batch of antibiotics in January 2012 I continued to get sinus infections
every few weeks.
So what is a sinus infection?
Most often, sinus infections develop after a cold. Sinus
infections are the result of inflammation or swelling of your sinuses. When
your sinuses become filled with fluid or clogged, bacteria can grow causing an
infection.
Other than colds, sinus infections can be caused by other
methods:
- Exposure to dust, dirt, pollen or
any other irritants in the air
- Excessive mucus production
- Blockage in the drainage duct due
to an obstruction
- Bacteria travelling from the respiratory tract or other bacteria such as streptococcus pneumoniae
What are the symptoms of a sinus infection?
- Yellow, foul smelling nasal
discharge
- Pressure and pain in the face
- Headaches
- Fever
- Nasal obstruction
- Congestion
- Cold symptoms that seem to get
worse and do not improve
- Sometimes sinus infections may be
accompanied by a cough
Generally, if your cold symptoms last for more than 10
days, it is best to see a doctor to make sure you do not have a sinus
infection.
My Case
After the first few days of taking antibiotics the
swelling in my face greatly decreased and my pain levels were reduced. By the
time I had finished the first course of antibiotics the infection appeared to
have gone. However, this was short lived. Within a week of finishing my
antibiotics the face pain and pressure returned. This was a continuous cycle
and I was taking a course of antibiotics every other week. As I am quite sensitive
to a lot of drugs, I find it difficult to take most antibiotics and I have an allergy
to penicillin. This was a problem for my doctor when attempting to prescribe an
antibiotic to treat my infections. After trying and being unsuccessful with a
few different pills, I eventually started to take Doxycycline. Each time I started
a course of antibiotics with 2/3 days my pain was minimal and my breathing was
a lot better. My asthma which is usually quiet mild, had been playing up since
the operation and was exuberated when I had the sinus infections.
When I was next reviewed by my surgeon at King’s in May
2012, he advised that I had a nasal cavity scan. This was essentially, a CT
scan of my sinuses. This was conducted on 28th May 2012. I went back
for the results on 2nd July and was referred to Ear, Nose and Throat
at Guy’s hospital. The results showed some soft tissue in the nasal cavity but
no obstruction of the drainage ducts. My surgeon suggested that I could have
the titanium plates and screws removed as I was experiencing pain in the lower
jaw. Mr Matthews wanted to rule out any other causes for the sinus infections
and advised that I saw an ENT specialist before proceeding with the plate
removal.
After being on and off of antibiotics since January, my
GP suggested I could try and blast out the infection with a one month course. This
would hopefully kill any lingering bacteria. I was apprehensive as I had
conducted some research into the long term effects of using antibiotics and knew
that I could end up becoming “immune” to Doxycycline and this would mean I would
have no other antibiotics to cure my infections. I was a little desperate and wanted so bad to
be “normal” so I agreed with the doctor’s advice and was put on a 30 day course
of Doxycycline. I remember feeling so drained and tired but I was relieved to
have less pain and pressure in my face.
I saw Mr Roberts the ENT specialist on 1st
October 2012. After explaining my problems with pain and breathing, Mr Roberts
examined me using an endoscope. This is a small tube like device which was
placed through the nostril into the nasal cavity. It was quite uncomfortable
and hurt a little when it touched my soft tissue. He advised that there was
nothing he could do for the moment and suggested that my surgeon should remove my
maxilla plates and screws. As I was having pain and muscle issues around my
mandibular plates, I decided I would like all my plates and screws removed from
my face.
I saw Mr Mathews on the 29th October and was
still taking course of antibiotics every couple of weeks. After discussing the risks of the operation I
was booked in for plate removal surgery at King’s on 6th December
2012.
Available now
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Lots of love always,
Steffie
x.x.x
Hi Stefanie,
ReplyDeleteThank you so very much for writing this blog! As someone just starting this process, knowing about all of your experiences has been so helpful. If you don't mind me asking...when you had your hardware (for lack of a better word) removed in Dec. 2012, did they remove all of the plates and screws or did you choose to leave some of them intact? Also, since having everything removed are you feeling any better? I hope so!
Thanks again Stefanie. All of the best.
Lena
Hi Lena, thank you for the comment. I had all my plates removed. The top ones were causing obstruction as the screws were in my nasal cavity and the bottom ones were removed due to pain and the fact the plates and screws were visible externally. To be honest with you,even if the bottom were not causing problems i would removal all of them. I had to have surgery anyway, so might as well removal all the metal work. It is nowhere near as bad as the first operation.
ReplyDeleteI have TN. Just had the new Balloon Sinusplasty , seeing ENT today. I stumbled upon this in Trigeminal Group. You have been through a great deal! Thank you for sharing so others can learn. Daryla
ReplyDeleteThank you for checking my blog out Daryla. Hope you are not suffering too much.
ReplyDelete