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Oral Surgery/Foul Sinus Drainage weeks after orthognathic surgery


I had a one piece le fort as well as a saggital split performed nearly four weeks ago.  Approximately two weeks post surgery, I was still experiencing nasal discharge, eapecially when trying to "open" while eating.  Surgeon didn't seem too concerned.  Since then, the discharge has turned an awful brownish yellow and has a very strong odor.  It seems to come more from my left nostril than my right.  My surgeon started me on cipro to combat any infection.  I've now been on it for five days.  Odor is still very strong if not worse (my husband was sitting next to me and said, "wow!  I can smell you!" Amount of drainage doesn't seem as bad as five days ago.  However, this is really starting to worry me.  I do have a follow up with my doc in two days but wanted a second opinion... Is this very common?  My friends who've had it done expressed that they experienced drainage but not the foil odor or taste.  I did not have my palate split at all.  My dentist also can't tell quite what the odor would be caused by this far post surgery and five days into an antibiotic.  What are the possible diagnoses?  Could it be from a left over piece of gauze?  Could my sinuses have been punctured?  Are there other secondary infections associated with this surgery?  I have also been using ocean spray saline mist.  It's starting to leave a rotting taste in my mouth, as well, almost like rotting blood.  Do i get the drainage cultured?  Any help and insight would be appreciated.

Kay, Thank you for your question. It is possible that you might have a post operative infection. When a LeFort I is performed, the sinuses are entered and cut in order to move the maxilla. Unfortunately, infections do happen and they happen for a number of reasons. The best thing that you can do is to follow your surgeons directions. It seems like you area and you are on antibiotics. Since you are describing that the drainage is getting better, that is a good sign. Take a look at your gums on the top and make sure they are pink in color or close to the same color that they were prior to surgery. I hope that helps.

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James M. Ryan. DDS, MS; Board Certified Oral and Maxillofacial Surgeon


Dr. Ryan's expertise is in the field of Oral and Maxillofacial Surgery. Specifically, Dr. Ryan is an expert in Orthognathic Surgery. He holds uniques experience as the former Assistant Program Director of the Oral and Maxillofacial Surgery Residency Training Program at Washington Hospital Center where he trained residents to perform these complicated surgical procedures. Additionally, Dr. Ryan also has a tremendous amount of experience in reconstruction of the maxillofacial skeleton related to trauma and tooth loss. Dr. Ryan is an expert in 3 dimensional treatment planning for Orthognathic Surgery, Dental Implant Surgery and Wisdom Teeth removal. To learn more about Dr. Ryan, his full profile can be seen at


Diplomate of the American Board of Oral and Maxillofacial Surgery with current hospital affiliations at: Washington Hospital Center Holy Cross Germantown Hospital National Institute of Health/NIDCR

American Dental Association. American Association of Oral and Maxillofacial Surgeons. District of Columbia Society of Oral and Maxillofacial Surgeons. District of Columbia Dental Society. American Board of Oral and Maxillofacial Surgeons. Health Volunteers Overseas.

Journal of Oral and Maxillofacial Surgery Journal of The American Dental Association

S.U.N.Y @ Stony Brook- B.S. in Biochemistry, Stony Brook, NY. Northeastern University- M.S. in Perfusion Technology, Boston, MA. D.D.S.- New York University College of Dentistry, New York, NY. Certificate and Chief Resident- Washington Hospital Center, Washington, DC. Clinical Fellow- The Johns Hopkins Hospital, Baltimore, MD.

Awards and Honors
Dr. Ryan has received numerous awards including: 2006 American Association of Oral and Maxillofacial Surgeons Dental Student Award, Washington Hospital Center 2008 Nurses' Choice Physician Collaboration Award, 2009 Resident Research Summit Scholarship Award, and the 2011 Outstanding Surgical Attending in the Department of Oral & Maxillofacial Surgery at Washington Hospital Center. He has also authored/coauthored and published several journal articles and held several teaching positions,including assistant professor, while at NYUCD.

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