Dr. Syed Peerzada Tehmid Ul Haque
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have a fever, intense pain, and nerve damage. I had surgery a few weeks ago. I think I have been injured or got nerve damage from the surgery. The pain is extremely severe. Please help. Thank you.
Hello,
Welcome to icliniq.com.
Thanks for writing in, and I understand your concern. Could you please elaborate more about your symptoms? What kind of intense pain are you having and in which part of the body? What sort of nerve damage do you think you have? Regards.
Patient's Query
Hello doctor,
Thank you for your response.
I had a tumor in my cheek 15 years back called pleomorphic adenoma. I had the surgery after three years for the same. They removed the salivary glands as well. The surgery went fine. This year it recurred, and I had to do another surgery. The doctor did not cut in the same spot that had a high risk of injury, so he cut directly through my cheek to remove it. After that, I had intense pain in my cheek. They are not sure what went wrong that is why I need to find a solution to my problem. I researched and found out that certain nerves are close to my surgical area called as the maxillary branch. I saw that it is related to trigeminal neuralgia nerves. Could that be why I have so much pain? Please give me your opinion on this. Regards.
Hello,
Welcome back to icliniq.com.
So, you have had pleomorphic adenoma, and you must have been managed surgically with a superficial parotidectomy. After that, you had a recurrence, and a second surgery was performed. Did they make an intraoral approach to the deep lobe? Neurological deficits are more common following surgery and the facial nerve is most at risk. What is the distribution of your pain? Do you have any facial weaknesses? Thank you.
Patient's Query
Hello doctor,
Thank you for your response. The cut was from outside, not from inside the mouth. So, they cut through my cheek. The area feels a bit numb and there is a lot of pain. The cut is closer to the ear. Please give me your opinion on this. Regards.
Hello,
Welcome back to icliniq.com.
How long have you had this pain now? Is there anything outside like any swelling or redness around the incision site? Any excessive sweating or flushing of this region? Does this pain radiate to any other site, or it is confined to the incision site? Have you noticed any weakness of the face or abnormal movements of the face? Thank you.
Patient's Query
Hello doctor,
Thank you for your response. It has been three weeks since the surgery and pain occurred. I do not have any redness from outside the area. Yes, I sweat a bit when I eat. I have had this problem since the first surgery. It does not bother me a lot. I think my facial movements are normal, except that I find it difficult to eat, move the muscles, or talk because it is painful. I feel headaches almost all the time. I feel electric shocks and sometimes burns on the surgery area and behind it, almost behind the head. I get a lot of pain in my forehead too. It feels like three veins and nerves on my forehead get painful, often with the same electric and burning sensation on it. And I get the same feeling on my thigh and leg. I have lost my concentration on things due to this. I have developed too much anxiety and depression. It would not have managed it if my parents and siblings were not around. I do not think I can manage to take care of myself completely. What do you think is happening to me? Regards.
Hello,
Welcome back to icliniq.com.
Does this happen all the time, or does it happen in bouts and paroxysms? Is there any triggering stimulus like the smell of food? Or when you try to eat, and does this pain develops suddenly when you try to eat? You are right that pain seems most likely of neurogenic origin. In my opinion, it is the first bite syndrome. Regards.
Patient's Query
Hello doctor,
Thank you for your response. It happens all time. The pain develops on its own. I also have tinnitus. The first bite syndrome, is it because of the injury or the tumor? Was there a reckless move from the surgeon that caused this? I do not think I have the first bite syndrome. I searched on the internet and saw the symptoms are not similar to what i described earlier. Regards.
Hello,
Welcome back to icliniq.com.
You had surgery just three weeks earlier. The surgery is an injury of sorts accompanied by inflammation and the attendant signs of pain, tenderness, and swelling. It takes almost six weeks for a full recovery. The symptoms may subside and improve over time. Since there is no discernable local cause of pain, neuralgia pain is more likely. The other reason could also be your temporomandibular joint. Regards.
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Otolaryngology (E.N.T)
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