Posted by Xanthro (64.236.243.243) on February 04, 2002 at 17:05:19:
In Reply to: I don't know what I have but it is debilitating! posted by Becks on February 02, 2002 at 20:16:55:
Here is some info I found on the web for you.
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What are the symptoms of Sluders Syndrome? For the past 7 months I have had an intense and continous toothache(upper and lower right jaw and earache(right ear). Pain always starts with a toothache and then develops into an earache.In search of being helped, I have had one root canal, stayed on antibotics for 3 months for sinus infection, had 2 CT scans, and seen 2 dentists, one allergist and one ENT surgeon. Last diagnosis was Sluders Syndrome because: for an examination my right nostril was stuffed with a cotton ball soaked in AFRIN, shortly thereafter I noticed my pain had lessen considerably. By using AFRIN for 4 days, the pain went away only to return within 2 weeks(I caught a cold). Used Afrin again, pain became less.
Discussed these findings with ENT and he reviewed CT scan and said a good chance of Sluders Syndrome, minor surgery would take care of the problem. Why at age 43, female, good health, does this pain arrive suddenly one day and not go away. Are these the symptoms of Sluders Syndrome? Is surgery really the answer? I now use AFRIN once in the morning and FLONASE once at night. Pain still remains, but not as intense. Normally the pains kicks in about 11 every day, some days more so than others. By continuing on this schedule, is it likely that eventually, my pain will go away? Should I seek another opinion? If so, what type of doctor?
Reply: -------------------------
Sluder's syndrome refers to sphenopalatine neuralgia. Some have questioned whether this is a unique entity or whether it is simply a form of cluster headache. Pain is usually felt in and around the eye, cheeks, roof of mouth, base of the nose, upper jaw, and teeth. Reference of pain to the ear, nape of neck, or shoulders has also been described. The diagnosis can be made by decongesting and anesthetizing an area in the back of the nasal passage (the posterior end of the middle turbinate) usually with topical cocaine or a mixture of afrin or neo-synephrine with lidocaine. A more permanent block can be achieved with injection of phenol or alcohol into the greater palatine foramen which is an opening in the hard part of the roof of the mouth through which the greater palatine nerve passes (which is felt to be the source of this type of neuralgia). Some physicians recommend a surgical procedure known as a vidian neurectomy which is an operation in which the offending part of the nerve is removed - this requires entering the maxillary sinus located in the cheek and removing a part of the back wall of the sinus - the nerve is located behind the sinus.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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