Face, Nose and Sinus pain: Other

Face, Nose and Sinus pain: Other:

The face, nose and sinus structures are predominantly supplied with sensation from a nerve coming through the skull base called the “trigeminal nerve”. It consists of three branches, upper (ophthalmic), middle (maxillary) and lower (mandibular). It is the fifth cranial nerve and these branches are known as V1, V2 and V3! Pathology involving one of these branches can cause pain in the distribution of other branches or in more remote areas according to connections of the trigeminal nerve with other nerves in the skull. This is called “referred neuralgia”. An understanding of the anatomy and function of this nerve and its connections is necessary to explain and diagnose headache causing conditions in this region.

The following conditions are representative but not all inclusive.

Facial Cellulitis (skin infection)
Infections generally due to staph or strep causing inflammation, redness, swelling and pain in skin which can spread to involve adjacent areas or spreads internally to cause brain abscess, meningitis and death (severe skin infections can cause serious complications !!)
Aggressive treatment with antibiotics often by intravenous therapy and attention to the causative lesion (eg abscess or boil) and predisposing conditions (eg poorly controlled diabetes)

Tumours
Benign and malignant
Primary (arising locally) or secondary (spreading from other sites in the body)
These tumours cause pain predominantly from involvement of branches of the trigeminal nerve or involvement of blood vessels

Temporal Arteritis
Autoimmune inflammation of the artery of the “temple region”. Often presents with frontal and temporal headache. Common in the elderly and can be diagnosed on basis of blood tests and artery biopsy. May involve the artery of the eye and cause blindness. Treated with steroids and immune suppression.

Trigeminal Neuralgia
A syndrome consisting of recurrent excruciating shooting or stabbing pains of brief duration involving any part of the face supplied sensation by the trigeminal nerve. Also called tic douloureux
Classification:Idiopathic (ie, no cause found)
Central Lesions
Primary & Secondary causes
Demyelination (breakdown of the lining of nerve fibres in the brain)
Cerebrovascular Disease

Author: Contact Details
Anthony Guiney 100X100
Mr Anthony Guiney MBBS .FRACS

Profession: EAR NOSE THROAT, HEAD & NECK SURGEON
Address: Essendon ENT, Head and Neck Clinic
62 Buckley Street Essendon 3040
Suburb: Essendon
Phone: 03 9375 2099
Also consulting in Blackburn

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Key Words: sinus pains, sinus, sinusitis, rhinosinusitis, rhinitis, tumours, infections, sinus infection, sinus headaches, nose pains, nose, trigemminal neuralgias, temporal arteritis, facial cellulitis, ent specialist, ent surgeon, ear nose throat specialists,

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