Nasal Congestion and Pain After Dental Surgery - Otolaryngology

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Nasal congestion and pain following dental surgery, particularly after wisdom tooth extraction, can be quite distressing and may arise from several interconnected factors. In your case, the development of dry socket (alveolar osteitis) after the extraction likely contributed to the initial pain and discomfort, which can radiate to other areas, including the head and nasal passages. This is not uncommon, as the nerves in the jaw and those in the nasal cavity are closely linked.

When a tooth is extracted, especially in the lower jaw, there is a risk of complications that can affect nearby anatomical structures, including the sinuses. The lower wisdom teeth are located near the mandibular canal, which houses the inferior alveolar nerve, and in some cases, the roots of the teeth may extend into the maxillary sinus. If the extraction site becomes infected or inflamed, it can lead to referred pain in the nasal area, resulting in congestion and discomfort.

Your history of nasal septum deviation and turbinate hypertrophy may further complicate the situation. These conditions can predispose individuals to chronic nasal obstruction and sinus issues. Although you mentioned that previous endoscopic evaluations did not reveal significant problems, it is possible for nasal conditions to fluctuate. The inflammation from the dental procedure could exacerbate pre-existing nasal issues, leading to increased congestion and discomfort.

The symptoms you describe, such as unilateral nasal pain and pressure extending from the eyebrows to the forehead, suggest that there may be some degree of sinus involvement. While you have been treated with antibiotics, which can help if there is a bacterial infection, they may not address other underlying issues such as inflammation or structural abnormalities.
It is also worth noting that the sensation of nasal congestion can sometimes be a result of referred pain from dental issues. The trigeminal nerve, which innervates the teeth, gums, and parts of the nasal cavity, can cause overlapping pain sensations. This means that even after the dental issues are resolved, the sensation of nasal congestion may persist due to nerve sensitivity.

Given that your nasal congestion has not fully resolved, and considering your previous nasal surgeries, it would be prudent to follow up with an ENT specialist. They can perform a thorough evaluation, potentially including imaging studies like a CT scan of the sinuses, to assess for any new developments such as sinusitis or other complications. Additionally, they can evaluate the function of your nasal passages and determine if any further intervention is needed to alleviate your symptoms.

In summary, the nasal congestion and pain you are experiencing post-dental surgery could be attributed to a combination of factors, including the effects of dry socket, pre-existing nasal conditions, and possible referred pain from the dental procedure. A comprehensive evaluation by an ENT specialist is recommended to identify the underlying cause and develop an appropriate treatment plan.