Campos A, Solomons N B, Armengot M, Zapater E, Basterra J
Servicio ORL, Hospital General Universitario de Valencia.
Acta Otorrinolaringol Esp. 1998 Nov-Dec;49(8):615-20.
Headaches and facial pain are common complaints. In many cases patients are referred to an otolaryngologist to determine if head pain is sinus related. In the absence of other nasal or sinus symptoms, some rhinogenic headaches can be overlooked or misdiagnosed. A complete history and thorough ENT examination, including nasal endoscopy, with or without coronal CT scans, is the key to the correct diagnosis. Subtle exploratory findings such as minimal inflammatory changes or anatomic abnormalities of the ostiomeatal complex area may cause pressure resulting in facial pain. When medical treatment fails to produce sustained relief, surgery may be considered. Current worldwide thinking firmly supports the endoscopic endonasal approach as a safe and effective form of treatment in patients with nasal and sinus disease. We prospectively assessed 67 patients who underwent FESS for rhinogenic facial pain in the absence of other nasal or sinusal symptoms. The overall success rate was 93%. Only 5.9% of our cases had some minor complications. No major complications occurred.
头痛和面部疼痛是常见的主诉。在许多情况下，患者会被转诊至耳鼻喉科医生处，以确定头痛是否与鼻窦有关。在没有其他鼻部或鼻窦症状的情况下，一些鼻源性头痛可能会被忽视或误诊。完整的病史和全面的耳鼻喉科检查，包括鼻内镜检查，无论有无冠状位CT扫描，都是正确诊断的关键。一些细微的探索性发现，如最小限度的炎症变化或窦口鼻道复合体区域的解剖异常，可能会导致压力，从而引起面部疼痛。当药物治疗无法产生持续缓解时，可以考虑手术治疗。目前全球的观点坚定地支持鼻内镜下鼻内入路作为治疗鼻和鼻窦疾病患者的一种安全有效的治疗方式。我们前瞻性地评估了67例在没有其他鼻部或鼻窦症状的情况下接受功能性内镜鼻窦手术治疗鼻源性面部疼痛的患者。总体成功率为93%。我们的病例中只有5.9%出现了一些轻微并发症。没有发生重大并发症。
