septum surgery and lip twitch

[louiec6683]

Well, I'll give this another try none of My post have been going through. Back in July I had septum surgery with turbinate reduction two weeks After the surgery I developed Bronchotis and was on 2 weeks of z pack then levaquin. My problem is that I developed a lip twitch/spasm very hard to see when looking at it, for about four weeks now. I have been to MY gp who took blood all normal. Went back to the ENT who said My turbinates were swollen gave me spray was not concerned about twitch, said give it a week and see a Nureo. Saw the Nureo did a eeg normal, exam normal. ordered a brain Mri waiting for results. Nureo stated it will most likely be normal had one three years ago for headache. My upper teeth have started to bother me now. I am concered that I have some sinus cancer or something. I had CT scan the day before surgery on sinus which was normal. Does a Brain Mri show part of the sinus cavaity, what does this sound like to you? have Mild TMJ and sleep apnea and I do grind My teeth while sleeping I have been told... thanks

[John Kenyon, CNA]

Hello -

These sorts of fine muscle twitches (fasiculations) are common enough and very annoying, and you've had surgery in an area where nerves pass through en route to the upper lip, so it's really hard to say whether the surgery, the TMJ (another possible cause) or just the usual "no reason at all" apply here. I feel pretty safe in saying there's unlikely any way you could have undetected sinus cancer, which is pretty rare to begin with.

An MRI of the brain can, coincidentally, show up some parts of the sinuses, but a CT of the sinuses specifically can also be done, is much quicker, and can be targeted very specifically at the area of concern. However, it sounds as though the imaging has all been done adequately and what remains now is to see whether the twitching will resolve on its own or if you may eventually need to have the nerve ablated (which could be done if the twitching becomes crazy-making, but would likely result in some unacceptable numbness and even potential paralysis of the lip).

Best bet is this is due to residual irritation of the nerve due to the surgery, possibly also aggravated by TMJ, and will most likely resolve on its own. This sort of thing can be recurrent and can sometimes last for weeks at a time, even without the sort of history you have.

Good luck to you. Please follow up with us as needed.