Facial Pain Flashcards
1
Q
A patient presents with facial pain lasting 3 days. This has happened twice in the past year. What other information would make you think that it’s sinusitis?
A
- post coryzal
- dull throbbing pain/pressure - forehead, cheek, between the eyes and occipital
- worse on bending foreward
2
Q
What is the management of acute rhinosinusitis?
A
- analgesia (covers 80% of cases)
- intranasal decongestion (1 week only)
- saline irrigation
- Consider intranasal steroids if severe or prolonged
- Abx Tx if bacterial or co-morbidity
3
Q
When do you refer a patient with sinusitis to ENT?
A
- I/P suspected intracranial/orbital involvement
- O/P 3 or more courses of Abx in a year
4
Q
How do you manage chronic sinusitis?
A
- W/ or W/O nasal polyposis:
- intranasal steroids
- Abx as and when
- prolonged macrolide tx
- ENT referal for polypectomy, septal correction, other surgery
5
Q
What complications of sinusitis are there?
A
- periorbital cellulitis
- Brain abscess
- meningitis
6
Q
What are the other differential diagnoses for facial pain?
A
TTTMMF
- Temporal Arteritis
- Trigeminal neuralgia
- TMJ dysfunction
- Migraine
- Medication over use headache
- Functional pain
7
Q
How does trigeminal neuralgia present?
A
-severe sudden stabbing pain in the maxilla or mandible
8
Q
How do you treat trigeminal neuralgia?
A
-carbamazepine +/- nerve blocks
9
Q
What is TMJ dysfunction about?
A
- referred pain to the deep ear, periauricular area and cervical regions
- WORSE on chewing
10
Q
How does one manage TMJ dysfunction?
A
- jaw rest (stop eating pussy)
- analgesia (hit the good stuff)
- bite raising appliance (get the tools in)
