[Neuralgia of the trigeminal nerve and pterygopalatine ganglion as a complication of paranasal sinusitis].

Out of 520 patients with paranasal sinusitis, 41 subjects (7.9 +/- 2.3%) developed complications in the form of neuralgia of the trigeminal and nasociliary nerves (37 patients) or the pterygopalatine ganglion (4 patients). In this group cases of chronic sinusitis were predominant when compared to those of acute sinusitis: 58.5 +/- 15.2% versus 41.5 +/- 15.2%. These patients had: frontal (20 cases), maxillary sinusitis--12 cases, and poly- and pansinusitis--9 cases. Purulent and cystic forms were more common. The duration of the diseases was less than 5 years in 17 out of 24 patients with chronic sinusitis and it varied from 6 to 20 years in the rest. Bilateral sinusitis was identified in 17.1 +/- 11.6%, right unilateral in 49.0 +/- 15.5%, and left unilateral in 34.2 +/- 14.8% patients. In 10 patients allergic origin of sinusitis was documented. Manifestations of neuralgia of the trigeminal and nasociliary nerves and the pterygopalatine ganglion developed according to the topographic spread of pathologies in the paranasal sinuses. On the right side they occurred in 26 patients (63.4% +/- 15%). The symptom complex of facial painful attacks was related to the pattern of sinusitis as well as to concomitant diseases, deviations from the normal structure of the paranasal sinuses and deformations in the oral cavity. It was understood that the trigeminal and pterygopalatine complications were secondary. Therefore it was first necessary to arrest inflammation in the paranasal sinuses and to eliminate nasal deformation. General and local (surgical and drug treatment) therapy proved efficient relative to both sinusitis and neurological complications in 39 patients.(ABSTRACT TRUNCATED AT 250 WORDS)