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Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Facial pain is a common presentation in ENT clinics and in the general population. The structure of the consultation will follow possible causes of the disease, but it must be stressed that the medical history is critical in the diagnosis as the majority of patients will be normal on examination. The face has multiple innervations and referred pain must be considered. Broadly, facial pain can be divided into sinogenic and non-sinogenic in origin. Sinogenic facial pain can be caused due to acute chronic rhinosinusitis but is uncommon in chronic rhinosinusitis (CRS). Non-sinogenic facial pain has a number of causes, including neuropathic (e.g. migraine, tension headache, midfacial segment pain), cranial neuropathies (e.g. trigeminal neuralgia, trigeminal autonomic cephalgias), dental pain, temporomandibular pain and myofascial pain.
Face
Published in A. Sahib El-Radhi, Paediatric Symptom and Sign Sorter, 2019
Facial pain, like any other pain, is an unpleasant sensory and emotional experience. The term is used to describe, on looking at the face, facial pain before a pain condition is diagnosed (pre-clinical pain). Facial trauma caused by an accident is excluded, as there is a clear cause for the pain. Facial pain has a long list of disorders including muscular-ligament inflammation (e.g. temporomandibular joint, salivary gland disease, sinusitis), dental (e.g. periodontal disease) and neurological causes (e.g. trigeminal neuralgia, cluster headache, post-herpetic neuralgia). Assessing facial pain and localising the source of the pain in children can be difficult, particularly in infants and young children. Nevertheless, diagnosis is usually possible by taking a good history and using pain assessment techniques classified as self-reporting, behavioural observation (such as facial expression, crying, forceful closure of the eyes) and physiologic measures (such as tachycardia, pupil dilatation).
Diagnosis and Management of Facial Pain
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Rajiv K. Bhalla, Timothy J. Woolford
Patients with unrelenting pain in the teeth, gingival, palatal or alveolar tissues often see multiple dentists and have multiple irreversible procedures performed and still have their pain. Common diagnoses include atypical odontalgia, persistent orodental pain, or if teeth have been extracted, phantom tooth pain.37 One possibility is that these pain complaints are due to a neuropathic alteration of the trigeminal nerve, but more likely is a diagnosis of persistent idiopathic facial pain (see below). Treatment may include pharmacological medications that suppress nerve activity. The common medications used for atypical odontalgia and phantom tooth pain include gabapentin, tricyclics, topical anaesthetics and opioids.
Tailoring and optimization of a honey-based nanoemulgel loaded with an itraconazole–thyme oil nanoemulsion for oral candidiasis
Published in Drug Delivery, 2023
Amal M. Sindi, Waleed Y. Rizg, Muhammad Khalid Khan, Hala M. Alkhalidi, Waleed S. Alharbi, Fahad Y. Sabei, Eman Alfayez, Hanaa Alkharobi, Mohammed Korayem, Mohammed Majrashi, Majed Alharbi, Mohammed Alissa, Awaji Y. Safhi, Abdulmajeed M. Jali, Khaled M. Hosny
For overall health and a high quality of life, oral health is crucial. In 2012, the World Health Organization defined oral health as the absence of mouth or facial pain, oral infections or sores, and other disorders that restrict a person’s ability to engage in with his daily and psychosocial activities (World Health Organization, 2012). Oral diseases continue to be a neglected area of global health despite the significant social and financial costs they impose on many nations (FDI World Dental Federation, 2015). Most adults have tooth decay, and 15% to 20% of middle-aged adults have serious gum disease (Buset et al., 2016). Poor dental health may be linked to such diseases as diabetes, heart disease, stroke, pneumonia, and other respiratory illnesses, according to the literature (Silva et al., 2015). Another typical reason for headaches and ear and facial pain is disorders of the jaw (Katz et al., 2010). Dental clearance prior to medical procedures such as cardiac surgery, cancer/bisphosphonate therapy, and radiation therapy reduces the systemic and oral side effects of these procedures (Rajan et al., 2014).
Simultaneous hemorrhage of multiple cerebral cavernous malformations of the insular lobe and Meckel’s cave: a case report and literature review
Published in British Journal of Neurosurgery, 2023
Xiaolong Wu, Xu Wang, Gang Song, Mingchu Li, Ge Chen, Hongchuan Guo, Yuhai Bao, Jiantao Liang
A 59-year-old male was admitted with 2 months of left-sided facial pain on 18 October 2018, and 10 days of speech slurring and limited movement of the right upper and lower limbs. Facial pain was primarily localized to the cheek and mandibular regions of the left side, and was described as feeling like an electric shock upon touching, shaving, brushing teeth, or chewing. Cranial magnetic resonance imaging (MRI) revealed the presence of multiple hemorrhagic intracranial lesions. Conservative treatment failed to relieve facial pain, although the patient reported complete relief of the right-sided limb movement disorder. Ten days prior to surgery, the patient suffered recurrence of this movement disorder. The patient has a history of hypertension that was effectively controlled with medication. The patient’s brother had a history of suspected CM.
Effect of neuropathic pain on sphenopalatine ganglion block responses in persistent idiopathic facial pain
Published in Neurological Research, 2023
Samet Sancar Kaya, Şeref Çelik, Erkan Yavuz Akçaboy, Hamit Göksu, Gökhan Yıldız, Şaziye Şahin
The International Headache Society defined persistent idiopathic facial pain (PIFP), previously termed atypical facial pain, as persistent facial pain that does not have the features of cranial neuralgias and is not attributable to another disorder [1]. The pain is often in the form of severe persistent unilateral facial pain that is deep or poorly localized, recurring daily for more than 2 h per day and is usually dull, aching, or nagging quality. The pain does not follow the distribution of any peripheral nerve, and neurologic examination and imaging studies are usually normal, in which there is no obvious cause [2]. Although the etiopathogenesis of PIFP is not clear, there are those who claim that PIFP is neuropathic pain, as well as those who suggest neurophysiological mechanisms in the brain [3–6]. The diagnosis of PIFP is often difficult as it is an exclusion diagnosis. Since the prognosis of the disease is not very good, patients are exposed to unnecessary tests and procedures for alternative diagnosis and treatments. PIFP can be significantly difficult to treat for the patient and clinician. Usually, attempts are made to use tricyclic antidepressants and antiepileptic drugs, and interventional procedures targeting the sphenopalatine ganglion (SPG) are applied in patients who do not respond to medical treatment [3,7].