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Chronic sinusitis. Toothache, ear pain, pain in cheek. Taken antibiotics. Losing patience

Hi I have been to the doctors 4 times in the last 2 months and have been diagnosed with Chronic Sinusitis but 2 months on the pain is still as severe as ever, I have severe toothache in every tooth on the right side, severe ear ache on the right side that has a squelching sound when i massage it, and severe pain in my cheek, this has been going on now for over 2months and I have been prescribed various antibiotics and sprays with no effect whatsoever, I am losing patience as I have now not slept for close on 7weeks properly
Asked On : Tue, 11 Dec 2012
Answers:  1 Views:  91
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Question is related to
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General & Family Physician 's  Response
Dear Concerned.,

Thanks for writing to us.

The symptoms could be primarily due to Chronic Sinus infection in Maxillary sinus bilaterally right > could be even due to turbinates hypertrophy(inferior),maxillary sinus polyposis,Deviated nasl septum(DNS) etc.,
Pls undertake the basic blood/urine examinations including assessment of your glycemic status/immunology or HIV Status/nutritional status-hypoprotienemia/anemia.
Sputum for Culture and sensitivity /Sputum for AFB and PCR etc.
In addition radiological tests including PNS X ray ,Chest PA View.
These tests are to be done to arrive at a definitive diagnosis and to know the co-morbid conditions. The pain in the cheek could be due to Chronic maxillary sinusitis.The ear ache could be as a result of middle ear infection passed on through the Eustachean Tube .Do you also have any Ear Discharge?
In addition you do have severe tooth ache on the right side. The Tooth Ache associted with Ear Ache on the same side is called Referred Otalgia.This has to be differentiated in consultation with ENT and Dental surgeons.The dental surgeon may advice you for an OPG film /individual tooth X-Ray and decide on further management.If it is referred otalgia ,it will be cured by dental treatment.
Coming to the definitive treatment available as the best resort, CT-navigated endoscopic surgical clearance of both the maxillary sinuses and also lavage in an ENT set up. In addition cuture and cytology of lavage specimen has to be done and then therapy has to be instituted.
You may continue with empirical antibiotics/analgesics/decongestants/Steam inhalations ,until you go for the endoscopic clearance and lavage for definitive results.
Wishing you the quickest recovery.,

Best Regards.,

Dr Lt Cdr ASN Bhushan.,

Answered: Wed, 12 Dec 2012
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