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鼻中隔成形术后迟发性神经性疼痛

Delayed-Onset Neuropathic Pain after Septoplasty.

作者信息

Koumpa Foteini-Stefania, Ferguson Mark, Saleh Hesham

机构信息

Imperial College NHS Trust, London, UK.

出版信息

Case Rep Otolaryngol. 2021 Dec 22;2021:9966318. doi: 10.1155/2021/9966318. eCollection 2021.

Abstract

Postoperative pain following a septoplasty is expected to be mild and limited to a few days after the operation. Chronic pain following the procedure is rare. No cases of delayed-onset neuropathic pain or allodynia have been described in the literature. This paper presents a case of delayed-onset neuropathic pain after septoplasty in a previously pain-free asthmatic patient that was successfully managed by administration of intranasal local anaesthesia. Physical examination and imaging excluded any other cause of neuralgia. A literature review revealed reports of chronic pain in patients following septoplasty if there were nasal contact or compression points or nasal tumours. Separately, acute postseptoplasty allodynia is documented in iatrogenic maxillary nerve damage. However, delayed-onset neuralgic pain, exacerbated by certain environmental triggers, has not been previously described. Facial pain can be debilitating; successfully managing this neuralgic pain with administration of intranasal local anaesthetic had a substantial effect on the patient's quality of life.

摘要

鼻中隔成形术后的疼痛预期较为轻微,且仅限于术后几天。该手术后出现慢性疼痛的情况较为罕见。文献中尚未描述过迟发性神经性疼痛或异常性疼痛的病例。本文介绍了一例鼻中隔成形术后迟发性神经性疼痛的病例,该患者为既往无疼痛史的哮喘患者,通过鼻内局部麻醉成功得到治疗。体格检查和影像学检查排除了神经痛的任何其他病因。文献综述显示,如果存在鼻接触或压迫点或鼻肿瘤,鼻中隔成形术后患者会有慢性疼痛的报告。另外,医源性上颌神经损伤会记录到鼻中隔成形术后急性异常性疼痛。然而,此前尚未描述过由某些环境触发因素加剧的迟发性神经痛。面部疼痛可能使人衰弱;通过鼻内局部麻醉成功治疗这种神经痛对患者的生活质量有重大影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8126/8716246/adb2df4cfe42/CRIOT2021-9966318.001.jpg

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