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Cheek Pain After Eating Or Drinking, Done Tonsillectomy. Any Concerns?

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Posted on Sun, 26 Aug 2012
Question: I have a 6 yr old 8days s/p tonsillectomy. C/o transient bilateral cheek pain following any thing in mouth (food, drink, water, candy, etc) More specifically, the center (chubby part) of the cheek. Very transient but very severe. No other complaints, throat, ears, teeth, jaw fine. MD's cause = referred p! and to chew gum which is not possible at this time. Any concerns? Salivary gland concerns? Normal?
doctor
Answered by Dr. Dr. Naveen Kumar Nanjasetty (6 hours later)
Hi

Thanks for the query

The pain over the cheek could be due to either the temporomandibular joint problem or trauma over the buccal mucosa while performing tonsillectomy.

Over stretching of the temporomandibular joint and straining of the muscles holding the joint one of the commonest problems noticed following tonsillectomy. The inflammation of the joint causes difficulty in opening the mouth and eating as there is pain over the muscles holding the joint. The masticator muscle is an important muscle holding the joint which passes over the middle 1/3 of the cheek; the straining of the muscles could be causing this pain.

Secondly, there could be trauma to the buccal mucosa while performing tonsillectomy which could be in a healing phase. Hence stretching of the scar can cause pain.

Finally, it is very unlikely that there could be any salivary gland problem. There are three major salivary glands such as parotid, submandibular and sub lingual salivary glands. Parotid glands are located in front of the ear and any blockage of the gland would be causing swelling over the front of the ear and the pain would have been referred into the ear. Rest of the glands is situated below the mandible and the tongue. Hence, inflammations of those glands are also ruled out.

I would suggest you to give your daughter anti-inflammatory medicines such as ibuprofen to reduce the pain. Also, try giving her plenty of water to drink and semisolid food.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Naveen Kumar Nanjasetty (7 hours later)
Thank you Doctor for you detailed response. Can we expect a normal recovery time/prognosis? Will the NSAID increase her risk for bleeding complications (s/p day 9)?
doctor
Answered by Dr. Dr. Naveen Kumar Nanjasetty (13 minutes later)
Hi

Thanks for writing back

Q: Can we expect a normal recovery time/prognosis?
A: Yes, it will definitely improve within a week or two with anti-inflammatory medicines.

Q: Will the NSAID increase her risk for bleeding complications (s/p day 9)?
A: No, NSAIDs will not increase the risk of bleeding in the post tonsillectomy patients. You can safely administer it to your child.

I wish her speedy recovery; all the best.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Naveen Kumar Nanjasetty

Otolaryngologist / ENT Specialist

Practicing since :2001

Answered : 2542 Questions

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Cheek Pain After Eating Or Drinking, Done Tonsillectomy. Any Concerns?

Hi

Thanks for the query

The pain over the cheek could be due to either the temporomandibular joint problem or trauma over the buccal mucosa while performing tonsillectomy.

Over stretching of the temporomandibular joint and straining of the muscles holding the joint one of the commonest problems noticed following tonsillectomy. The inflammation of the joint causes difficulty in opening the mouth and eating as there is pain over the muscles holding the joint. The masticator muscle is an important muscle holding the joint which passes over the middle 1/3 of the cheek; the straining of the muscles could be causing this pain.

Secondly, there could be trauma to the buccal mucosa while performing tonsillectomy which could be in a healing phase. Hence stretching of the scar can cause pain.

Finally, it is very unlikely that there could be any salivary gland problem. There are three major salivary glands such as parotid, submandibular and sub lingual salivary glands. Parotid glands are located in front of the ear and any blockage of the gland would be causing swelling over the front of the ear and the pain would have been referred into the ear. Rest of the glands is situated below the mandible and the tongue. Hence, inflammations of those glands are also ruled out.

I would suggest you to give your daughter anti-inflammatory medicines such as ibuprofen to reduce the pain. Also, try giving her plenty of water to drink and semisolid food.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon