Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
146 Doctors are Online
Ask a Dentist   »  

Feeling tightness in lower cheekbone. CT scan showed acute sinusitis. Taking agumentin. What is wrong?

User rating for this question
Excellent
Answered by

ENT Specialist
Practicing since : 1991
Answered : 2534 Questions
Question
His is my recap/follow up-
A few months ago I noticed what seems to be a tightness in the lower right cheekbone just above the upper last 2 back teeth where the cheekbone meets. Tightness seems to be from the skin pulled a bit tighter is how I can explain it. I went to my GP and he probed around and didn't feel anything out of sort as far as glands. I had a impacted wisdom tooth removed a few other in the area more than a year ago so there are no teeth at the point in question.

If I run my fingers back on bother sides - inside my mouth I can feel on side is larger, GP gave me 5 days of antibiotics and assumed possibly sinus related. No change after the course of antibiotics. GP then ordered a CT scan.

CT Scan - results - INDICATION: ACUTE SINUSITUS -There is a tiny amount of mucosal thickening along the floor of the left maxillary sinus and there is an 8mm cyst along the floor. There is minimal thickening and a small amount of fluid along the posterior left sphenoid. There is no bone destruction. The infundibula are patent. The uncinate processes are correctly oriented. There is a moderate sized right Haller cell. There is moderate nasal septal deviation to the right. The mastoids are aerated. The limited included intracranial structures are unremarkable.

Conclusion - Minimal sinus thickening, right Haller cell and nasel septal deviation. Small amount od fliud in the left sphenoid.

GP - wrote a script for 10 days of Agumentin - no change after the course. I don't have any pain just a tight feeling in the area and seems larger - this occurred in a 1 month period. Does not seem to have changed in size in the past 2 months.

My question is - would an 8mm cyst make the cheekbone area larger or is that too small to notice? Would any blocked or partial blocked gland/duct cause this sensation and would it have shown on the CT scan?

I have a few bad teeth toward the front that need extracted and thought maybe abscess might have formed way back in that area - just guessing . I have no pain just can feel that the area is larger when I open and lose my mouth a bit. Could there be some type of growth/mass? I assume that would have shown on the CT scan.

Any thoughts appreciated?

Thanks

Posted Sat, 13 Apr 2013 in Dental Health
 
 
Answered by Dr. Sumit Bhatti 22 minutes later
Hi,

Thank you for your query.

1. If you can share the CT images, it would help more than the report.

2. An 8mm cyst in the floor of the Maxillary Sinus should be insignificant and would require no treatment.

3. A year after the removal of the wisdom tooth and some more teeth would gradually cause subtle changes in the bite and hence this tightness may be as a result of muscle spasm.

4. Get a Dental opinion. You may require a dental splint to ease the tightness.

5. it is unlikely that a growth would be missed on a CT.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feeling tightness in lower cheekbone. CT scan showed acute sinusitis. Taking agumentin. What is wrong? 18 minutes later


I have quite a few missing teeth in the area and was thinking that this might be related to some structural changes/degradation over time. Also would a partially blocked parotid duct be a possibility? As the enlarged area seems to be where the duct travels along the lower cheek line. I would assume that would have show on the CT also? This was unenhanced can without contrast.

Thank-you Dr. Bhatti for the quick reply.
 
 
Answered by Dr. Sumit Bhatti 11 minutes later
Hi,

Thank you for your query.

1. The Parotid Duct (Stensen's Duct) will nor show up easily on a CT Scan. The parotid glands are easily visible.

2. A direct examination of the opening in the cheek (normally opposite the second premolar) may help.

3. Get an Ultrasound (USG) of the neck and salivary glands done. A Sialogram may help identify a partially blocked Parotid Duct.

4. Unlike the submandibular salivary gland duct stones, Parotid ducts tend to be blocked by smaller sand like debris which do not show up on X-rays. This is because the nature of the secretion is more serous than mucoid.

5. Nuclear imaging of the salivary gland s is also possible to evaluate function.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feeling tightness in lower cheekbone. CT scan showed acute sinusitis. Taking agumentin. What is wrong? 10 minutes later
Thanks again Dr. Bhatti - you have given me logical answers to my questions for better understandings and possibilities.

Have a good day
 
 
Answered by Dr. Sumit Bhatti 4 hours later
Hi,

Thank you for writing back.

Wish you a speedy recovery,

Regards.
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Lab Tests
Medical Topics

The user accepted the expert's answer

Ask a Dentist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor