Chronic facial pain following diseases affecting the maxillary antrum. The influence of peripheral impulses from the maxillary air sinus is not significant in their maintenance

Coincidental supraorbital neuralgia and sinusitis

Headache interpreted as treatment failure may be encountered after FESS or pharmacological treatment for chronic sinusitis. This persistent symptom may lead, even in the presence of minimal sinus disease, to frequent office visits, medical treatment, primary surgery, and revision procedures. A prospective study of patients with a documented history and imaging-verified sinus disease with persistent atypical refractory headache were evaluated. Diagnostic measures included injection of local anesthetic and response to carbamazepine. Severe neuralgia of the supraorbital nerve was identified in 11 patients with chronic sinusitis, treated either medically or surgically before inclusion in the study. Eight of the patients underwent surgery for sinus disease, and five of them had revision surgery because of persisting complaints. All patients responded favorably to the local injection, and eight were treated with carbamazepine. In certain cases, headache in sinusitis patients may be caused or aggravated by supraorbital neuralgia. Sinus disease is possibly a causative factor but conceivably plays the role of a "red herring." This readily diagnosed and treated coexistence may be more prevalent than recognized formerly.

Facial pain. I. A prospective survey of 1052 patients with a view of: definition, delimitation, classification, general data, genetic factors, and previous diseases

1052 patients with facial pain have been examined and followed up by the author for an 18-year period. The patients are classified according to type of attack into: Typical Trigeminal Neuralgia (brief pain paroxysms with pain-free intervals). Atypical Trigeminal Neuralgia (pain paroxysms with intervals of pain or paroxysms lasting for minutes). Non-neuralgiform Facial Pain (pain lasting or occurring for long periods). The material was equally distributed between patients with Neuralgia and Non-neuralgiform Facial Pain. In the majority of cases Trigeminal Neuralgia occurred after the age of 50. Non-neuralgiform Pain mainly between 30 and 50. There is a majority of women with Non-neuralgiform Pain. No genetic factors could be demonstrated. A detailed registration of previous diseases in the central nervous system, the peripheral nerves, and the facial structures revealed no relation to important aetiological factors.