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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carotidynia is a form of vascular neck are face pain in which the vascular change occurs in the carotid artery in the neck. The disorder is not uncommon, and most patients have a prior history of migraine. They present with pain in the neck and face, and are often thought to have a disorder such as chronic sinusitis or trigeminal neuralgia. Diagnosis can be made from the type and location of the pain and the finding of a tender and swollen carotid artery on the same side. Carotidynia responds to the prophylactic medications used for migraine, often disappearing in weeks or months. In some patients the syndrome may become recurrent or chronic, with a variable response to medication.
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PMID:Carotidynia: a cause of neck and face pain. 44 85

The operative approach and findings of 250 osteoplastic frontal sinusotomy operations performed from 1956 through 1972 at the Massachusetts Eye and Ear Infirmary are reviewed. Indications for surgery were symptomatic and/or complicated disease of the frontal sinus, including primary chronic sinusitis and osteoma or trauma with or without associated infection. Immediate postoperative complications were minor. Follow-up of at least three years was obtained in 83% of the patients, and 93% of these have no significant symptoms to date. A distressing problem of persistent postoperative frontal pain is discussed in detail. Revision surgery has been performed in 6% of patients due to recurrent frontal sinus infection. The reasons for failure are anlyzed, and recommendations are made to minimize the possibility of recurrence.
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PMID:Osteoplastic frontal sinusotomy: an analysis of 250 operations. 94 59

The primary or secondary reconstruction of the facial access after Caldwell-Luc and the more selective resection of sinusal mucous membranes can be important in the therapy and prevention of postoperative complications such as neuralgic facial pain, formation of cysts and chronic sinusitis. The different osteoplastic sinus operations are described and the use of a pedicled bonelid is illustrated. The most common accepted ethiology of post-operative pain is based on the formation of scar-tissue. Postoperative pain is first being treated conservatively, while in case of persisting pain an exploration with dissection of the infra-orbital nerve and reconstruction of the facial defect can be indicated. In a retrospective study of 36 patients the results of our surgical therapy are illustrated.
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PMID:[Pedicled facial bone flap for closure of the approach in Caldwell-Luc type sinus operations. Its role in the prevention of postoperative complications]. 144 90

Sinusitis may be caused by bacteria, viruses, or trauma and may appear in immunosuppressive settings. Acute sinusitis is most commonly diagnosed on the basis of pain and discharge; endoscopic or fiberoptic examination may be helpful in less obvious cases. Radiography can identify maxillary, frontal, and sphenoid sinusitis; transillumination can be used if radiography is undesirable. Culture and Gram stains may help determine the appropriate antibiotic therapy. Surgery may be necessary if the frontal or sphenoid sinus is involved, or if ethmoiditis is progressing to orbital cellulitis. In chronic sinusitis, endoscopic examination and computed tomographic scanning are useful for diagnosis. Chronic sinusitis may be associated with airway disease, aspirin allergy, and such diseases as cystic fibrosis. Antibiotic therapy that acts against anaerobes and beta-lactamase-producing organisms should be chosen. Surgical treatment includes intranasal and external ethmoidectomy, antrostomy, and, on occasion, obliteration of the involved cavity.
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PMID:Medical and surgical management of sinusitis in adults. 172

Kartagener syndrome consists of situs inversus, chronic sinusitis, and bronchiectasis. A 39-year-old woman known to have Kartagener syndrome presented with complaints of left upper abdominal quadrant pain. Suspicion of cholelithiasis was confirmed with ultrasound and oral cholecystogram. The patient underwent a laparoscopic cholecystectomy. Standard techniques were modified in mirror image fashion to provide access to the left upper quadrant. This unusual presentation of chronic calculus cholecystitis in a patient with Kartagener syndrome demonstrates the adaptability of laparoscopic cholecystectomy technique.
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PMID:Laparoscopic cholecystectomy in a 39-year-old female with situs inversus. 183 60

Intranasal and sinus disease may result in disabling head and facial pain and serious complications. Awareness of the symptoms of acute and chronic sinusitis and their various presentations will enhance diagnostic accuracy and improve patient outcome. It is important to remember that the nasal mucosa is under autonomic control. Sinus symptomatology, whether from anatomic abnormality or chronic inflammation, may occur with and will typically be exacerbated by increased parasympathetic outflow or reduced sympathetic tone. Thus, the possibility of underlying intranasal or sinus disease must be considered in patients with atypical migraine or vascular instability headaches. A new appreciation of the impact of sinusitis on facial and head pain syndromes is developing among otolaryngologists because of the improved diagnostic capabilities afforded by combined intranasal endoscopy and modified CT. In the past, patients with nasal complaints and facial pain who had normal plain radiographs were often passed off as "chronic nasal complainers" and given decongestants or the recommendation to see a psychiatrist. On the other hand, patients with symptoms and radiologic abnormalities often underwent radical surgery aimed at the maxillary or frontal sinus, sometimes with persistence or worsening of their complaints. Now, however, underlying causes for these problems can often be found in the ostiomeatal complex and corrected with minimally invasive surgery. In general, the major sinuses appear to be more sensitive to pain before the development of chronic mucosal changes. Minor disease in critical locations within the ostiomeatal complex may therefore give rise to greater symptomatology than diffuse disease in less critical sites. Although head CT may be a routine part of the neurologist's examination in patients with headache or facial pain, routine CT techniques are inadequate to evaluate fully the ostiomeatal complex and sinuses and must be modified to rule out adequately pain of sinus origin. Nasal endoscopic examination provides a noninvasive examination by which patients may be selected for sinus CT and is a necessary part of a complete evaluation. Close cooperation between the neurologist and otolaryngologist-head and neck surgeon is therefore essential for the accurate diagnosis of this often puzzling group of patients.
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PMID:Nasal and sinus pain: current diagnosis and treatment. 307 26

Acute otitis media and chronic otitis media with effusion are generally caused in children by the bacteria found in the nasopharynx. In growing numbers of young patients, beta-lactamase-producing strains of Branhamella catarrhalis and Staphylococcus aureus have recently emerged as causative organisms. The antimicrobial agent selected for treatment should be effective against whatever pathogens have been associated with failures of symptomatic treatment in the community. Acute or chronic sinusitis in children is overlooked and poorly understood because so many children have frequent episodes of upper respiratory infection. To relieve acute symptoms and prevent suppurative complications, antimicrobial treatment is indicated. Children with persistent pain or fever may require surgical intervention and/or treatment with another antimicrobial agent. Recurrent acute sinusitis needs further evaluation and may be associated with a tooth abscess or cystic fibrosis.
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PMID:Update on antimicrobial therapy for otitis media and sinusitis in children. 391 21

A case of subperiosteal orbital hemorrhage associated with chronic sinusitis is reported. A 57-year-old woman had a sudden onset of severe orbital pain and exophthalmos in the left eye. Computed tomography revealed a discrete round mass in the left retro-orbital space. An external frontoethmoidectomy was performed to evacuate the hematoma of the subperiosteal space. Additionally, the mucosa was edematous in the left ethmoid sinus. It appears that subperiosteal orbital hemorrhage in this case was caused by rupture of vessels which were inflamed as a result of sinusitis. Orbital hemorrhage associated with chronic sinusitis has rarely been reported. Diagnosis and treatment are discussed and etiologic factors are reviewed.
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PMID:Subperiosteal orbital hemorrhage associated with chronic sinusitis: a case report and review of the literature. 403 9

To answer the question Is it really sinusitis? one must take a careful history, look into the nose, palpate the infected sinuses, and obtain roentgenograms. A history of pain, mucopurulent discharge, nasal obstruction, and systemic involvement should be present for a diagnosis of acute suppurative sinusitis. Physical findings and the presence of a predisposing factor help in the diagnosis, and roentgenographically demonstrated changes of the involved sinus can substantiate it. Acute suppurative sinusitis necessitates antibiotic therapy, which should be continued for seven days after the primary symptoms are relieved in order to avoid recurrence or development of subacute or chronic suppurative sinusitis. Chronic sinusitis requires surgical intervention to remove the diseased mucosa, and the sinuses must be ventilated (oxygenated) for resolution to occur.
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PMID:It is really sinusitis? 662 9

Mucormycosis is the most acutely fatal fungus infection of man. The disease causes a characteristic pattern of clinical symptoms and signs, prompt recognition of which will permit immediate institution of antifungal therapy. Personal experience with 16 cases of the rhino-orbitocerebral form of mucormycosis is the basis of this report. The first of these patients was seen in 1959, and the last in 1981. All of the patients had one or more preexisting diseases, as follows: (1) diabetes mellitus, 13; (2) acute leukemia, 3; (3) terminal carcinomatosis, 1; and (4) chronic sinusitis, 1. The most common initial symptoms and signs were sinusitis, pharyngitis, nasal discharge, and orbital/periorbital pain. Proptosis and formation of a black eschar were only seldom among the initially apparent features. Hyphas were demonstrated in tissue sections in 14 of the 16 patients in whom biopsy was done. Rhizopus species were cultured in 11 of the 13 patients from whom material for culture had been obtained clinically. Five of the 16 patients survived. All of them had been treated with surgical debridement and with intravenous amphotericin B.
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PMID:Diagnosis and management of rhino-orbitocerebral mucormycosis (phycomycosis). A report of 16 personally observed cases. 664 48


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