Caldwell-Luc

This is an image of the Caldwell_Luc surgery.

http://www.exodontia.info/files/Caldwell-Luc_Approaches_to_the_Maxillary_Sinus.jpg

This is the surgery that was done to me on October 30, 2007 by an ENT whom I was seeing for tinnitus–ear ringing. It was done on both the left and right sides of my face. I was not told this was going to be done.

The pre-surgery MRI and CT reports note no polyps or any disease on the right side of my face, except for “a small ovoid soft tissue mass…in the right ethmoid air cells…” and “mild mucosal thickening…in the right maxillary sinus”—noted in the CT report. I had never seen any doctor for any nasal or sinus issue.

After the surgery, I was desperately ill. I had acinetobacter infection in my sinuses. I had never before had a sinus infection in 55 years of life. Acinetobacter is an antibiotic-resistant, hospital-acquired infection to which only very ill patients are susceptible.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870905/

My sinus mucosa had been ripped out. I was raw and infected. My inferior turbinates had been removed and I was smothering every minute of every day due to the condition Empty Nose Syndrome.

“Before surgery on an inferior turbinate is undertaken, a trial of medical management is mandatory.”

http://www.thefreelibrary.com/The+turbinates+in+nasal+and+sinus+surgery%3a+a+consensus+statement.+…-a098248242

“When taken to its extreme, the sequela of this lack of respiratory mucosa leads to a nasal cripple.”

http://journals.lww.com/co-otolaryngology/toc/2002/02000

I presented to otolaryngologist, Dr. F., at a large medical center in my city six weeks after the surgery. I was in agony, shaking and sobbing, gasping for breath. I was given antibiotics, but the infection was not cultured until I returned in much worse condition 5 weeks later. In fact, I was not cultured then, either. Dr. F had me finish a second round of the wrong antibiotic first, telling me that he could not squeeze me in for a culture until the following week. Obviously, he could have cultured the infection right then and there in his office.

I recently acquired this record from my first appointment with Dr. F: “The patient is status post sinus surgery on October 30, 2007, and presents with continued symptoms. The risks and benefits of the procedure were explained in detail and she elected to proceed.”

How likely is it that a patient with no nasal or sinus history elected to proceed with that?

On the Patient History form I filled out on the day of my first appointment with the ENT who did this surgery, I reported visual, cardiovascular, bladder, and immunologic symptoms due to a “CO exposure.” I also reported a long history of immunologic problems. Under “Respiratory, asthma, emphysema, lung,” I reported “none.” There is no other heading under which to report nasal or sinus problems and none are reported. On a separate page for reporting ear problems, I report “tinnitus.” This also is the only word on the referral form from my GP–tinnitus.

“Surgery is reserved for confirmed chronic sinusitis, per history, physical and CT as well as those who have not responded to medical therapy.”

http://www.urmc.rochester.edu/smd/RAD/neurocases/Neurocase238.htm

I took a letter to Dr. F from my GP: “She has never had a diagnosis of chronic sinusitis. She had never been seen here for any sinus problems prior to November 2007.” Dr. F would not take the letter from my hand.

“The Caldwell-Luc operation was first described in the late 1890’s.”

“The main complications associated with the Caldwell-Luc procedure include oroantral fistula (breakdown of the gum incision with communication between the mouth and sinus), rare osteomyelitis, infraorbital nerve injury with associated hypesthesia, injury to the tooth roots and tooth discoloration. When the mucous membrane of the antrum is totally removed, the sinus eventually regenerates nonciliated epithelium. It is unable to clear mucus as a normal ciliated sinus would. It is common for mucoid pus to occur postoperatively as the sinus is no longer able to clear itself of bacteria and mucus.”

http://www.urmc.rochester.edu/smd/RAD/neurocases/Neurocase238.htm

‘The Caldwell Luc operation is also carried out on the maxillary sinus. It is more radical than the intranasal antrostomy. The sinus is opened by through a cut between the gum and the upper lip, above the canine tooth. A hole is chiselled or drilled through the cheek bone. The lining of the sinus is scraped out. A large intranasal antrostomy is also made. The Caldwell Luc operation was done for almost 100 years, and can give good results for severe chronic maxillary sinusitis. It can cause severe interference with nerves to the teeth and face. One third of patients having Caldwell Luc surgery will have permanent numbness. Many will have painful sensitive nerve endings in the teeth or face. Caldwell Luc surgery is rarely done nowadays, but still has its place occasionally.”

http://www.entkent.com/FESS.html

According to Peterson’s Principles Of Oral and Maxillofacial Surgery, Volume 1, page 307, published in 2004, the Caldwell-Luc is referred to as “obsolete”: Google Book Link.

Two and a half years after the surgery, my face is caving in on the right, the side for which pre-op scans showed no sinus disease. I have been in unbearable pain for the past six months. My teeth are crashing together. I am unable to access appropriate medical care due to patient blacklisting.

http://www.patient-safety.com/blacklisting_patients.htm

~ by ens3 on June 13, 2010.

16 Responses to “Caldwell-Luc”

  1. i also had a caldwell luc proceedure in 2009,for chronic sinusitis, now i am left with nerve pain numbness and the area constantly feels like a new injury even 5 yrs later. Days to weeks after my surgery the Doctor would not return my phone calls. when i made a follow up appt. either he was booked out 2 months or they would call and cancel my appt last minute.
    That doctor was wrong to do this proceedure. Edina Minnesota

    • Edina, That is what they do. They ignore you. You are an inconvenient patient because you have been injured. I am so sorry this happened to you.

      It is doubtful there was any good reason to do this horrible “surgery” to you.

  2. I have done so many Caldwel Luc surgeries but never had patients coming back with any problems. I am really horrified to read the above reports.

    • According to Peterson’s Principles Of Oral and Maxillofacial Surgery, Volume 1, page 307, published in 2004, the Caldwell-Luc is referred to as “obsolete,” They are also considered a last resrt surgery for intractable sinus disease. Usually, this would only be for cancer or cystic fibrosis. However, I am glad your patients have not been harmed. And I am glad you are horrified. It is so very necessary for ENT surgeons to understand the suffering that can be and is being caused by ENT surgeries, especially turbinate reductions. I am aware of many lives of intolerable suffering as a result of them. I hope you will do more research and help to educate your colleagues.

  3. I had a cauld well luc done in July, 2013 and I’m still in terrible pain. I have had 4 previous sinus surgeries for polyps and back surgery, 3 c-sections, and had never experienced such pain or complications before. Two days after the surgery I got worse and then the weekend came so I called the Dr.office on Monday only to wait hours to speak to his nurse. I told her about the swelling and teeth and facial pain and was told it was normal. I told her I was taking percocet and advil and the pain was waking me up every few hours. By the time I got to see this too busy Dr. he said it looked like I was starting an infection ,wow really, like 2 weks ago, and put me on bactrum. Well 6 days went by and I was no better, so I spoke to the pharmacist at Walgreens who told me I should have seen an improvement by now. Again my busy Dr. couldn’t see me for another week and called in a script for prednisone. I went to my dentist to see if it was one of th 6 teeth that were killing me and he said no. He also asked me how long the stitches had been in my mouth and I said 5 weeks. He told me the stitches should have melted weeks ago and now they were a foreign object in my mouth. He asked me for my Dr. phone number and his assistant called my Dr. and got me an appointment for the next morning and of course my Dr. said it was looking better. I would never go back to that practice and if there was any way to prove malpractice I would. I’m still in pain!

  4. hi – very saddened to hear your story. I have undergone a caldwell luc procedure too and since then have been suffering from constant sinus infections and pain in my gums. I have been to numerous doctors. I was treated with penicillin IV for a month because of infection but did not recover. Could you please tell me how a culture was obtained in your case for the sinusitis and which antibiotic was found to be sensitive. Wish you a quick recovery.

  5. I’m really sorry to say this but the author of this report must be an complete idiot; please read the quote: “This is the surgery that was done to me on October 30, 2007 by an ENT whom I was seeing for tinnitus–ear ringing. It was done on both the left and right sides of my face. I was not told this was going to be done.” After this one I would have my attorneys run after him and them and sue the hospital.

    • No, I am not a complete idiot. I spoke to about 300 attorney, only one of whom agreed to take the case. However, when the physician who treated the injuries refused to testify against the surgeon, he said we could not go forward. The medical malpractice climate is such that it is almost impossible to even get a case into court. Surgeons routinely get by with murder now.

  6. I am in the 1/3 with nerve pain. When I woke from the procedure immediately I had nerve pain. He ignored me until I took some of my dads neurontin and found relief. I am left with permanent nerve damage on the right side if my face. I take neurontin 4 xs a day, elavil once a day and celexa once a day since 2004. It gives me almost complete relief. If I get breakthrough pain I take Ativan. The regimen works for me. With this I am able to function in life and pain free. I hope uve found relief as well.

    • Janis, I am not on pain meds. I improved greatly when abscessed tooth roots below the Caldwell-Luc site were discovered and the 2 teeth were repaired. However, I am having pain and infection again now. Not sure why or how this will end up. I am glad to hear that you found a solution.

  7. Your story is unbelievable! Removing turbinates for tinnitus?? I too have had an inferior turbinate removed because I had a tumor in that area and the surgeon had to remove the turbinate…I get that..but the aftereffects were never explained to me by him! I am fortunate to have another ENT who GETS it and is helping me. Take care, I hope you are much better, but I know, we dont really get better with this problem.

    • It truly is unbelievable that this was done to me. And that no other doctors reported the crime to the medical board.

      By God’s grace, my condition has improved, but I will always be less than I was before.

      I hope the best for you, too.

  8. Please inform us how you are these day. Was your health restored? Did you get correct surgery?

    • I am much improved, but my health will always be compromised. I still have a dry nose and facial pain. I lost alot of teeth. The only surgery I had had is dental implants.

  9. Just as Samson’s strength was in his hair, the spirit of God is in our nostrils.

    • Jospeh, That is true. What these doctors do is a crime against creation. Your words of wisdom bring comfort to those of us who have suffered this assault to our very nature.

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