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

The authors describe their experience involving 30 patients treated surgically for stubborn algesia during the development of cancers of the face and neck. Sectioning Jacobson's nerve which they suggested for 72 cases exclusively or mainly involving otalgia especially where the tumours was tonsillar, proved of great therapeutic value and took little toll of the patients. - Resection of Andersch's ganglion, difficult and often ineffective, should not be attempted. - On the other hand, when there is stubborn pharyngeal pain with otalgia, sectioning the IXth is remarkably successful. Likewise, where there is pain in the face or tongue and the floor of the mouth which fails to respond to opiates, partial microcoagulation of the pre-pontile root of the trigeminal nerve is an excellent solution. - Neurotomies of the IXth and the Vth, carried out in the cerebellopontile angle, are operations with simple sequelae. They have the outstanding advantage of permanently relieving the pain of these unfortunate patients.
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PMID:[Surgery of cancer pain. Section of the IX and V nerves in the ontocerebellar space, section of Andersch's ganglion and Jacobson's verve. Indications and results]. 5 89

In order to quantify the pain associated with first trimester abortions and to analyze its influences, patient observations by doctors and attending counselors and patient interviews were conducted. Of the 2299 patients, 86% received 20 cc of lidocaine as paracervical anesthesia (14% received less) and 76% choose to receive 5 mg oral diazepam preoperatively (4% received 3-8 intravenously during the procedure). Patients compared their pain with other familiar types of pain. Doctors and counselors rated the pain during each of 8 specific stages of the abortion (examination, speculum insertion, tenaculum placement, administration of paracervical local anesthesia, uterine sounding, cervical dilatation, vacuum aspiration, and sharp curettage) as compared with the average pain they had observed. In addition, counselors rated the degree of apprehension with which the patient faced the procedure. These methods were analyzed on the basis of internal consistency among each group and agreement across the 3 sources and were found to be sufficiently dependable for the purpose at hand. The pain most often experienced was less severe than an earache or toothache, more severe than a menstrual pain or headache. Physicians and counselors agreed that vacuum aspiration is the most painful stage followed by dilatation and sharp curettage. Pain was positively associated with 1) age of 15 years or less, 2) with gestation of less than 7 weeks or more than 12 and with dilatation on a curvilnear basis, and 3) with patient fear. Despite expectations to the contrary, administration of 5 mg oral diazepam did not reduce pain.
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PMID:Pain of first-trimester abortion: its quantification and relations with other variables. 44 87

In most cases, the cause of an earache is obvious. If the cause is not apparent after careful inspection, a systematic approach to the associated causes and sites of referred pain is necessary. Glue ear is the most frequent cause of hearing loss in children. The diagnosis, investigation and management have been described. Recurrent earache from pressure change or from recurrent middle ear infection is an important clue to the presence of a glue ear.
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PMID:Earache and glue ear. 62 22

Tonsillectomy results in severe throat pain, ear pain, and trismus until the exposed and inflamed muscle becomes covered with regenerated mucosa. Sucralfate binds with the fibrinous exudate of duodenal ulcers, forming a protective barrier that promotes healing. If a similar buffer could be created in the tonsillar bed, morbidity may be diminished. A double-blind, randomized study was completed in 34 adult patients to determine whether sucralfate, given four times daily for 10 days as a swish and swallow, would significantly reduce postoperative pain and promote healing and recovery. Sucralfate significantly lowered postoperative throat pain, otalgia, and trismus. Sucralfate is a safe and well-tolerated topical agent that offers significant pain reduction and may promote healing in tonsillectomy patients.
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PMID:Sucralfate in alleviating post-tonsillectomy pain. 140 84

Phylogenesis, ontogenesis and anatomy explain the close relationship between temporo-mandibular joint and the middle ear and can therefore help understanding otologic symptoms such as: otalgia which often correspond to articular and muscular pain irradiation (coming from sterno-cleido-mastoid, lateral and medial pterygoid, deep layer of the masseter and temporal muscles); acouphens and ear block sensation that could be caused by a spasm extension of the manducatory (i.e. medial pterygoid) to levator and tympani tensors. These three muscles, which originate from the first branchial arch, have a proprioceptive sensitivity and share the same innervation. What is more tensor and levator veli exchange certain muscular fibers. Tensor tympani spasm can be held responsible both for a decrease or abolition of the Klockhoff's reflex, together with a decrease of the stapedian reflex, the latter due to tympani rigidity induced by a spasm of the tensor tympani.
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PMID:[Otologic manifestations of the pain dysfunction syndrome of the stomatognathic system]. 141 Dec 17

Twenty-two cases of early squamous cell carcinoma of the arytenoid cartilage staged as T1 according to the 1983 American Joint Committee for Cancer Staging Classification system were reviewed. Eighteen percent of the patients showed no symptoms. In the remaining 82%, the main presenting symptom was pain in the form of sore throat, odynophagia, or otalgia. Radiotherapy and partial laryngeal surgery were the options retained for the treatment of the larynx. A "watch and wait" policy or preventive treatment of the ipsilateral jugulocarotid lymph nodes were the treatment options retained for the neck. Significant differences were noted in terms of local and nodal recurrence between the two programs. Results indicate that partial laryngeal surgery with total arytenoidectomy and preventive treatment of the neck appear to be advisable for this particular type of primary lesion.
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PMID:T1 squamous cell carcinoma of the arytenoid. 149 55

Fifty-one subjects with documented intra-articular pathology refractory to non-surgical therapy underwent temporomandibular joint (TMJ) disc repositioning surgery. Following surgery, subjects were evaluated for 6 months to 6 years by clinical examinations and questionnaires at designated times, and by postsurgical joint imaging. Significant decreases were noted in pain (headache, TMJ pain, ear pain, and neck/shoulder pain), the incidence of joint sounds and locking, and the presence of dietary restrictions. However, 35% of the subjects continued to have residual TMJ pain, and a similar percentage continued to need periodic nonsteroidal anti-inflammatory drugs for analgesia. Some degree of dietary restriction remained in approximately 50% of the subjects, and joint sounds persisted in a similar percentage following surgery. Mean mouth opening was improved by 8 mm, although lateral movements were increased by less than 0.5 mm. Surgery did not decrease the occurrence of jaw deviation, and disc position was unchanged in 86% of the joints imaged at an average of 2 years following surgery. Although TMJ disc repositioning surgery significantly improved pain and dysfunction in TMJ surgery patients, the improvement in disc position was not maintained in most subjects following surgery.
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PMID:Changes in signs and symptoms following temporomandibular joint disc repositioning surgery. 154 84

Two patients with cervical spine arthritis and ear pain were recently evaluated at our clinic. Injection of the C1-2 facet joints with local anesthetic plus corticosteroid resulted in relief of the pain. Therapeutic cervical facet injections may be indicated in cases of recalcitrant head and neck pain due to cervical spine arthritis.
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PMID:Ear pain due to cervical spine arthritis: treatment with cervical facet injection. 144 94

Intractable, unexplained deep-ear pain presents a rare, albeit significant problem in otolaryngological and neurosurgical practice. The authors review their experience with 18 cases of primary otalgia during the past 15 years. A total of 31 surgical procedures were performed. Seventeen patients had sequential rhizotomies and one patient had microvascular decompression alone. Based on the clinical diagnosis, the nerves sectioned were singly or in combination: the nervus intermedius (14 patients), geniculate ganglion (10 patients), ninth nerve (14 patients), 10th nerve (11 patients), tympanic nerve (four patients), and chorda tympani nerve (one patient). Microvascular decompression of the involved nerves was undertaken in nine patients, in whom vascular loops were discovered. Adhesions (six patients), thickened arachnoid (three patients), and benign osteoma (one patient) were other intraoperative abnormalities noted. The overall success of these procedures in providing pain relief was 72.2%, and the mean follow-up period was 3.3 years (range 1 month to 14.5 years). There was no surgical mortality. Expected side effects were: decreased lacrimation, salivation, and taste related to nervus intermedius nerve section, and transient hoarseness and diminished gag related to ninth and 10th nerve section. Four patients developed sequelae consisting of sensorineural hearing loss, vertigo, and transient facial nerve paresis. One patient had a cerebrospinal fluid leak and another developed aseptic meningitis as postoperative complications. Except when primary glossopharyngeal neuralgia is the working diagnosis, a combined posterior cranial fossa-middle cranial fossa approach is recommended for adequate exploration and/or section of the fifth, ninth, and 10th cranial nerves as well as the geniculate ganglion and nervus intermedius.
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PMID:Geniculate neuralgia: the surgical management of primary otalgia. 152 Mar 57

Temporomandibular joint (TMJ) dysfunction may manifest itself clinically by a variety of presentations ranging from headache, pre-auricular pain or tenderness, otalgia, to mandibular hypomobility. Some symptoms may mimic forms of facial pain such as: temporal arteritis, migraine, cluster headache, trigeminal or glossopharyngeal neuralgias, myofascial pain dysfunction, or muscle contraction (tension) headache. This article will focus on a relatively new diagnostic tool that may be used to examine the TMJ for intracapsular pathology which may be responsible for the presenting patients' symptoms.
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PMID:The role of diagnostic arthroscopy in the management of temporomandibular joint dysfunction. 196 Jul 86


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