Question: I have pain while swallowing and turning my head, what could it be? I had an abscessed wisdom tooth that caused my lymph nodes to swell and cause dysphagia several times within the last year and a half; it has always gone completely away leaving me asymptomatic. Feb of 2013 I became ill and the dysphagia began again. I was given antibiotics for suspected strep throat and pharyngitis. 2 weeks later I had my wisdom teeth extracted and developed necrosis of the bone and was subsequently put on a total of 5 weeks of antibiotics. The pain while swollowing has not gone away as of today. I have had a Laryngoscopy, Esophogram, Endoscopy, CT of the neck checking for an abscess and was diagnosed with a hetial hernia, gastritis and dyskinesia of the esophagus. My Gastroenterologist and PCP both have urged me to get a second opinion with another ENT saying the dysphagia is a separate problem. I was also sent for a Esophageal Motility Study that I was not able to tolerate. I was not able to swallow any saline without vomitting. What could be wrong for so long? I am very desperate, any info would be greatly appreciated. Thank you
Answer: Dental infections may often lead to infections elsewhere in the head and neck. Dental infections in the upper jaw (maxilla) may cause sinus infections, head and neck abscesses (pus pockets) and rarely even brain abscesses. Infections of the lower teeth can spread to the floor of the mouth- causing a potentially dangerous infection known as Ludwig’s Angina, or swollen infected lymph nodes or even potentially life threatening abscesses in the neck.
While I cannot say for sure, it seems likely that the infection of the lymph nodes you developed has resolved- or at least to your doctors’ best ability to determine. A CT scan with contrast should be able to detect any persistent infected lymph node.
The other findings that you have- a hiatal hernia with reflux, gastritis and finally dysknesia (incoordination) of your esophagus all are causes of dysphagia (difficulty swallowing). Pain while swallowing and turning the head is not uncommon when acid reflux from the stomach comes up as high as the throat- and may well be the cause of your symptoms. This can be usually be found on an ENT exam, or by testing to see if acid from the stomach does in fact come up to the throat (pH testing).
I wish I could tell you more precisely, but if you’re in the NY area, would be happy to see you here and try to better clear things up. If you make an appointment, please try to bring the results of the studies done so far and any scans.
Robert Pincus MD
Associate Professor Otolaryngology
NY Otolaryngology Group
Our office number is 212-889-8575- or you can email for an appointment request
________________________________________
