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