Sinus communication
 

I had #14 and #13 extracted on 03/03/2016. 14 had a 5 year old root canal. The root was close to the sinus. OS performed extractions. Recovery was very good. About 6 or 7 days later I sneeze snuck up on me and I stifled it without thinking. Last Sunday (about 2 to 3 days after sneeze) I tasted blood in post nasal drip and when I spit it out it had a little brown blood in mucus. From that point on everything started. When I drink fluids I can feel it go in to my sinus. My nostril burns. I feel pressure in my sinus and extraction area. Went back to the OS this past Thursday and he said I have a sinus communication. Prescribed antibiotic and told me to take Sudafed and give it time to see if it closes up. On Friday I took one Nexafed tablet and within minutes my tongue and mouth started a horrible burning. Three different pharmacists told me not to chance taking it again. I cannot get in touch with my OS until Tuesday. I could not stop crying on Friday due to severe anxiety over this. The crying seems to have been everything worse because yesterday my nostril on that side was inflamed and strong burning irritated feeling. I feel congestion in my sinus and pressure in my extraction site depending on how I move or talk. If I gently touch my nostril or sinus I feel a twinge of pain at the extraction site. Is this to be expected with a sinus communication? I simply want to know what is normally expected in terms of symptoms so I don't freak out more than I already am. Technically it has only been a week since I started feeling symptoms of sinus communication. Does it take longer than a week to close up? I can't take a decongestant and I am worried that will make it worse. Everything I read about, most people do not talk about nasal/sinus burning or inflammation, but rather liquids coming out. I would really be grateful for input. Thank you.

Hi Prayerworks,

It's best to not hold in a sneeze after a tooth extraction as that puts undue pressure on the sinus membrane. If you have to sneeze, cover your mouth with a tissue and sneeze with your mouth open. That will prevent the pressure from occurring up against the sinus membrane.

When you said Nexafed, I assume you meant Sudafed?

If you had a negative reaction to the Sudafed, and it sounds like you did, then do not use it again.

Your symptoms are not unusual with a sinus communication. However, the oral surgeon is the only one who knows the size of the sinus opening and he's the only one who know what the findings were when he removed those teeth. So it is best to call the oral surgeon, leave a message with his answering service for him to call you back or call his emergency number and speak to him. Let him know the reaction to the Sudafed and if he recommends something else. Also explain your current symptoms to see if he thinks they are concerning or not.

Bryanna

Thank you Bryanna. I feel better knowing that what I am feeling is normal for a sinus communication. Most sites I have checked mention nothing about nasal sinus discomfort. Actually a couple sites said they are usually painless. I beg to differ. Especially after a good cry. Lol.

May I ask you one more question? If it is deemed necessary that the communication be surgically corrected, is it usually a difficult or painful procedure? Is it like surgically removing a tooth? Hospital or in office?

Again, thank you!

If anyone else on here has had a sinus communication I would love to hear your experience. Many thanks!

Prayerworks,

The surgery to close a sinus opening from the oral cavity depends on the individual case. There are different surgeries that are done based on the patient and the circumstances.

It is usually done by an oral surgeon in his dental office under local or light IV sedation. So if someone does comment on their experience with this please know that it may be very different than your own situation.

Bryanna

Thank you for your response Bryanna. I notice most people when they talk about their sinus hole don't really mention pain in the nostril. Yet that seems to be my biggest symptom, burning pain way up in my nostril and if I touch it gently or the side of my nose it radiates to the extraction site. Most people don't seem to complain about that. Any ideas?

Prayerworks,

Actually in the clinical setting, your symptoms are heard frequently.

Everyone's case is a bit different due to size and location of the opening... infection status ... pain medication and pain threshold, etc. So the symptoms or degree of symptoms will vary.

Did you speak to the oral surgeon? When do you go back in to see him?

Bryanna

First of Bryanna, I can't thank you enough for taking of your time to address my concerns. You cannot imagine how much sleep i have lost over this.

I go back to my OS day after tomorrow. I am petrified as to what he will do. One thing i know for sure is the hole is not closing up. This coming Thursday will be three weeks since the extraction and the extraction site still looks like it has a way to go. Fluids are going into my sinus and out my nose and from time to time i taste the salty taste at the extraction site. If i breathe in through my nose, i feel a twinge of pain at the extraction site.

What i have not mentioned until now is that i am in remission from lyme disease and am hoping one doesn't affect the other. In an effort to clean up my body, i took the opportunity that my premolar was hurting to also extract the first molar next to it which had a root canal. I may have made things worse for myself.

I have searched the net high and low and i cannot seem to get any feedback as to how difficult or painful it is to correct this. No one in my circle has even ever heard of such a thing as sinus communication.

Prayerworks,

You have not read much info on it because every case is unique. There are surgical sites that talk about sinus repairs but you would not understand the techniques they are discussing.

Also, sinus perforations are not uncommon when an upper posterior tooth is removed. However, they are not always diagnosed at the time of the extractions and not until symptoms occur or they are so small that neither the oral surgeon or the patient knows they have one.

Most sinus communications heal on their own. However, some factors that can complicate the problem are the patients health, smoking, poor post operative care, infection, retained root tips of the tooth..... etc.

The salty taste is from the sinus not the extraction. Removing 2 neighboring teeth in the posterior maxillary arch at the same time frequently result in a sinus opening or perforation. Especially if one or both of those teeth were root canaled or infected.

When you see the oral surgeon, please request an xray of that area. Don't let him talk you out of having one. The xray may be helpful in visualizing the extent of the opening, the location and if there are any retained root tips.

If he does not treat the area, he will probably tell you to come back in a week or two. At that appointment another xray should be taken to compare to the last one.

Bryanna

Thank you Brianna. You have been very helpful. I will keep you posted.