Brief Answer:
Distinct problems when discussing eye/sinus infection vs Bells's Palsy

Detailed Answer:
Good morning and thank you for your question.

Bell's palsy is a disorder that affects the 7th Cranial Nerve at a location which is inside the skull proper....more specifically in the region of the pontine brainstem area. It occurs when the nerve I mentioned becomes irritated or inflamed for some reason causing the classic features of FACIAL PARALYSIS involving FOREHEAD, CHEEK, and LOWER area of the mouth. There is also usually some degree of trouble CLOSING the affected upper eyelid.

A sinus infection or even eye infection would be HIGHLY UNLIKELY the culprit in such an inflammatory reaction involving this nerve simply because an infection in either of those regions would have no access to the brainstem region where Bell's Palsy occurs. Indirectly speaking a VIRAL SINUS INFECTION could be transmitted to the eye region if a person were to contaminate themselves by getting mucus drops from the sinus drainage and then, rubbing it onto or into their eye...but this would not cause signs and symptoms of 7th nerve palsy. The eye would simply be expected to become red, inflamed, swollen. However, there would be no reason for there to be a paralysis or weakness of the UPPER EYELID as happens in Bell's Palsy. There would be no lack of lacrimation which would cause drying of the eyes and the irritated feeling one gets in BEll's Palsy, etc.

An ocular infection (even if viral) would be expected to run its course as all viruses do and disappear leaving no significant residual behind. On the other hand, because of the affectation of the 7th nerve and depending upon the cause it is possible to residual symptoms and problems involving eyelid closure and even ongoing issues of dryness of the eye due to lack of tear production can occur and persist for quite some time and in some cases never fully recover in Bell's Palsy.

The fact your doctor has prescribed Acyclovir, prednisone, and Advil suggests to me that they are likely thinking in terms of treating more the possibility of a BELL'S PALSY as opposed to a simple viral conjunctivitis or eye infection as it is most commonly referred.

You should also know that while it is true that most experts believe Bell's Palsy is caused by an activation of a Herpes virus what is no longer practiced as widely as before is the automatic use of Acyclovir or other antiviral agents in the acute treatment of Bell's. For a number of years it was believed that the use of the antivirals early in the course of the episode would lessen the intensity, duration of the spell, and perhaps hasten return to a better functioning baseline.

Now, for only the more SEVERE CASES of Bell's Palsy is it recommended that antivirals be used. Acute steroid medications such as PREDNISONE are still considered the mainstay of initial treatment but antivirals should be reserved for the more severe cases of Bell's Palsy as they've not been shown to be clearly effective and do carry a number of risks especially having to do with the development of kidney stones if not enough fluid hydration is used by the patient.

The bottom line in answering your question though is that it is highly unlikely that a sinus infection which could indirectly be spread to the eye as a viral conjunctivitis or similar problem would ultimately result in the presentation of BELL'S PALSY for the anatomic and physiological reasons I described above.

Viral infections of either sinuses or the eye are most commonly treated conservatively according to symptoms and they are expected to clear without major residual or consequence. Treatment of Bell's Palsy with antivirals nowadays in combination with oral steroids is considered appropriate only when the Bell's presentation is considered fulminant and severe. Otherwise, the use of symptomatic agents/approaches along with oral corticosteroids is considered sufficient while the process runs its course with hopeful return to baseline function in a period or weeks or even months.

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This query has utilized a total of 32 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Anesthesia with fenestration procedures

Detailed Answer:
I'm not a surgeon so I must defer to your surgeon's opinion but what I can tell you is that there are simpler and less complicated procedures of sinus surgery that are carried out under local anesthesia. I don't know that TWILIGHT is exactly what's done since there is quite a bit of instrument manipulation that must occur so matter how simple the procedure.

However, most experts tend to agree (from what I've read and what my patients have told me) that GENERAL ANESTHESIA, when done by very careful and diligent physician can make a procedure much less burdensome on both patient as well as surgeon. Also, certain conditions such as blood pressure can be more tightly controlled when the patient is under GENERAL which can be a problem if the patient is under local.

The answer really lies with the surgeon and with the complexity of the procedure. My feeling from research and in speaking with patients and colleagues is that GENERAL anesthesia is preferred for more complex or extensive sinus procedures while lighter or local forms of anesthesia can be done in patients who are good candidates in not having many physical problems to begin with and are getting only a small procedure done in only 1 sinus as opposed to multiple.

Once again, if I've provided useful and helpful information to your questions could you do me an appreciated act by CLOSING THE QUERY including some words of positive feedback along with a 5 STAR rating? Many thanks indeed for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 42 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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