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Thursday, December 12, 2013
Face and Jaw Surgery
Inside upper lip cyst
I had a non-cancerous cyst removed from my upper (left side) of my lip two years ago. Since all of the cyst was not removed properly I had to see an ORAL MAXILLOFACIAL SURGEON to try to repair what they called a neuroma. The doctor tried numerous procedures to correct what I call a `cut nerve". He has cauterized it, snipped it, and had glycerol injections three weeks ago. This has been a nightmare. I have had over 60 needles and 37 doctor visits over this period of time. The 5 surgeries were to repair the cut nerve and nothing has helped. The original pathology reports said non-cancer tan matter. (cyst) The cyst is gone now but, they are trying to repair the nerve damage that was done in a different area than the original cyst (center of my upper lip). The glycerol injections did not help. These injections were very painful for glycerol is very thick and the needle had to be thick also. The Doctor said this will break down the scar tissue. They want to see me in six months for more glycerol shots. I don`t feel I can go through that again. I can see the lumpy nerve damage and a white spot hanging out. I just don`t know who to turn to anymore. I have gone to another oral surgeon/Md and he said they cut a nerve and to let them fix it. Every time they do a procedure I think it will be the end of this, but, it`s always the same. I am constantly using the numbing agent `hurricane` for temporary relief. It feels like a paper cut with a lump, tight and pulling. Do you think this can ever be fixed? Thank you.
An incomplete removal of a cyst in the lip do not usually cause neuromas. There are no major nerve fibers present in the mid-upper lip to cause traumatic neuromas. Traumatic neuromas occur at the end of injured nerve fibers as a form of ineffective, unregulated nerve regeneration; it occurs most commonly near a scar, either superficially (skin, subcutaneous fat) or deep.
Local injection of glycerol for neuromas have shown very poor results. Your history suggests more of a neuralgia. The treatment of these depends upon the type of neuralgia. Some of the neuralgias can be treated by topical creams alone. Some are managed by medications and some by surgery. I cannot give a specific answer if this problem can be resolved without examination.
Likith V Reddy, MD, DDS, FACS
College of Medicine
University of Cincinnati