Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
ENT Specialist Kumluca State Hospital, ENT Clinic, Antalya, Turkey.
Acta Otorhinolaryngol Ital. 2018 Dec;38(6):485-496. doi: 10.14639/0392-100X-1721.
Facial pain remains a diagnostic and therapeutic challenge for both clinicians and patients. In clinical practice, patients suffering from facial pain generally undergo multiple repeated consultations with different specialists and receive various treatments, including surgery. Many patients, as well as their primary care physicians, mistakenly attribute their pain as being due to rhinosinusitis when this is not the case. It is important to exclude non-sinus-related causes of facial pain before considering sinus surgery to avoid inappropriate treatment. Unfortunately, a significant proportion of patients have persistent facial pain after endoscopic sinus surgery (ESS) due to erroneous considerations on aetiology of facial pain by physicians. It should be taken into account that neurological and sinus diseases may share overlapping symptoms, but they frequently co-exist as comorbidities. The aim of this review was to clarify the diagnostic criteria of facial pain in order to improve discrimination between sinogenic and non-sinogenic facial pain and provide some clinical and diagnostic criteria that may help clinicians in addressing differential diagnosis.
面部疼痛仍然是临床医生和患者面临的诊断和治疗挑战。在临床实践中，患有面部疼痛的患者通常会多次向不同的专家进行咨询，并接受各种治疗，包括手术。许多患者及其初级保健医生错误地将他们的疼痛归因于鼻窦炎，而实际上并非如此。在考虑鼻窦手术之前，排除非鼻窦相关的面部疼痛原因非常重要，以避免不适当的治疗。不幸的是，由于医生对面部疼痛病因的错误考虑，相当一部分患者在接受内镜鼻窦手术后仍持续存在面部疼痛。应该注意的是，神经和鼻窦疾病可能有重叠的症状，但它们经常作为共病同时存在。本综述的目的是阐明面部疼痛的诊断标准，以提高对鼻窦源性和非鼻窦源性面部疼痛的鉴别能力，并提供一些可能有助于临床医生进行鉴别诊断的临床和诊断标准。
