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  • Description:
  • The physical examination should carefully isolate sites of pain. Facial and oral cavity palpation can find sites of pain such as the temporomandibular joint, dental, supraorbital foramen neuralgia, and temporal arteritis. Nasal examinations should be done with and without a vasoconstrictive agent. Careful endoscopic evaluation should be performed to rule out any anatomic abnormalities or variations (Figure 1). Topical analgesics on possible sites of pain may relieve the pain and help locate the target site for treatment. The CT scan should be compulsively and carefully examined for anatomic variations. A narrow ostia with a lateralized uncinate and a dehiscent infraorbital nerve may point to a vacuum headache. Huge agger nasi cells or a narrowed frontal recess may cause barometric pain. A lateralized middle turbinate secondary to a severe septal deviation or a huge concha bullosa middle turbinate may block the maxillary, anterior ethmoid, and frontal drainage, resulting in medial orbit, eye, and frontal pain (Figure 2). Once all of the above measures have been taken, a decision regarding medical or surgical treatment can be made.
  • License:
  • Rights Managed
  • Rights Holder:
  • JAMA
  • License Rights Holder:
  • Copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
  • Asset Type:
  • Image
  • Asset Subtype:
  • Illustration
  • Image Orientation:
  • Landscape
  • Image Dimensions:
  • 590 x 528
  • Image File Size:
  • 57.7 KB
  • Creator:
  • James A. Stankiewicz MD
  • Credit:
  • Stankiewicz, J. A. (2000). Directed Functional Endoscopic Sinus Surgery and Headaches. , 126(10), 1277-1278. https://doi.org/10.1001/archotol.126.10.1277.
  • Collection:
  • Keywords:
  • Restrictions:
  • Property Release:
  • No
  • Model Release:
  • No
  • Purchasable:
  • Yes
  • Sensitive Materials:
  • No
  • Article Authors:
  • James A. Stankiewicz MD
  • Article Copyright Year:
  • 2000
  • Publication Title:
  • Publication Volume:
  • 126
  • Publication Issue:
  • 10
  • Publication Date:
  • 10/01/2000
  • DOI:
  • https://doi.org/10.1001/archotol.126.10.1277

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