CRS vs. migraine: which is the culprit in most headaches?

‘Sinus headache’ is a common diagnosis according to patients and primary care physicians, but relatively infrequent in the eyes of otolaryngologists. This study examines 104 patients with a primary headache syndrome (PHS) and 130 patients with CRS, looking at SNOT-22...

Pain control for patients with chronic pain following surgery

There is an increasing number of patients with a background of chronic pain presenting to the otolaryngologist. Patients with chronic pain require extra consideration in postoperative pain control due to risk of tolerance and dependence. This article summarises postoperative management...

Tramadol soaked nasal packs for post-septoplasty analgesia

Having had a septoplasty a number of years ago for the potential treatment of snoring, I was intrigued by this paper which compared the analgesic effect of tramadol-soaked and lignocaine-soaked nasal packs following septoplasty. In my practice, I have always...

Peripheral nerve stimulation for chronic refractory pain

Peripheral nerve stimulation (PNS) plays an important role in treating chronic refractory pain syndromes that manifest in limited distributions and overlap with areas of neurologic innervation. The process is generally thought to capitalise on the inhibition and activation of pain-related...

Sphenopalatine ganglion block in endoscopic sinus surgery reduces intra and post-operative morbidity

The authors present results of a meta-analysis to investigate the role of sphenopalatine ganglion block (SPGB) in reducing postoperative pain in endoscopic sinus surgery (ESS). An electronic database search (Pubmed, SCOPUS, Google Scholar, Embase, and the Cochrane Register of Controlled...

Occlusal splint, injections or arthrocentesis in myofascial pain

Facial pain is a fairly common complaint and may present in a myriad of symptoms. These patients present to both dentists and general practitioners and could end up referred to a number of specialists. Temporomandibular disorders may originate from either...

Hilotherapy for facial surgery patients?

Hilotherapy involves administering regulated cold compression through a facemask. The principle of this treatment involves cyotherapy as a traditional treatment for reducing inflammation, pain and swelling following trauma. It is believed that using hilotherapy (Hilotherm®), which uses a mask to...

Classification of maxillofacial pain

The patient that presents with oral and facial pain can prove a diagnostic conundrum. Whilst most often dental causes can explain the origin and help from our maxillofacial colleagues is warranted, it is useful to have a system for approaching...

Local dexamethasone infiltration in tonsillectomy

Intravenous dexamethasone is routinely given during tonsillectomy for its effects on postoperative pain and nausea. This Chinese randomised study divided 240 children undergoing tonsillectomy into three groups, receiving either no steroid, intravenous dexamethasone, or the same amount of dexamethasone infiltrated...

Argh! Facial pain! What to do??

We often come across patients with presentation of facial pain, but unless this is sinugenic in origin, our understanding and management of it can often be found wanting. Craniofacial pain is in fact highly complex and encompasses a wide range...