phenylephrine-hydrochloride and Neuralgia

Chronic refractory vasomotor rhinitis (VMR) is a debilitating condition that causes significant impairment of quality of life. The purpose of this study is to investigate the efficacy and potential side effects of endoscopic vidian neurectomy as treatment for patients with VMR.. This study was a prospective, intent-to-follow case series. Inclusion criteria were as follows: (1) patients with debilitating VMR refractory to medical therapy and with significant impact on quality of life; (2) negative allergy history and skin testing; and (3) negative computed tomography (CT) scan to rule out skull-base defect or cerebrospinal fluid (CSF) fistula. Patients underwent bilateral vidian neurectomy via a pterygomaxillary approach. Prior to surgery all patients underwent formal ophthalmologic testing to quantify preoperative ocular and lacrimal function. Ophthalmologic testing was repeated postoperatively at approximately 3 months. Patients also completed surveys regarding rhinologic outcomes including the Sinusitis Symptom Questionnaire (SSQ) and the 22-item Sino-Nasal Outcome Test (SNOT-22) at the following time points: preoperatively, and 1 week, 4 weeks, 12 weeks, 6 months, 1 year, and 2 years postsurgery. Descriptive statistics and analysis of variance (ANOVA) were undertaken.. Eleven patients (22 sides) underwent bilateral vidian neurectomy with pathologic confirmation of nerve section in all cases. Average follow-up was 19.4 months. Statistically and clinically significant improvement was measured for both the SSQ and the SNOT-22 and compared with the patients' baseline scores (p < 0.0001). Subscores for rhinorrhea and nasal congestions were also statistically significantly improved (p < 0.05). No incidence of permanent or measureable dry eye has been reported.. The data suggests that vidian neurectomy is an effective, safe, and definitive treatment for most patients with VMR refractory to medical treatment.

Topics: Adult; Aged; Aged, 80 and over; Cranial Nerves; Denervation; Endoscopy; Female; Humans; Male; Middle Aged; Neuralgia; Neurosurgical Procedures; Nose; Prospective Studies; Rhinitis, Vasomotor; Surveys and Questionnaires

Nasal pain is a challenging diagnosis and very little has been reported in the neurological literature. The nose is a sophisticated structure regarding its innervation, which is supplied by the first and second divisions of the trigeminal nerve. Painful cranial neuropathies are an important group in the differential diagnosis, although they have been described only scarcely. Here, we report a case that can conform a non-traumatic external nasal nerve neuralgia.. A 76-year-old woman was referred to our office due to pain in her left nose. She was suffering from daily excruciating attacks, which were strictly limited to the territory supplied by her left external nasal nerve (left ala nasi and apex nasi). She denied previous traumatisms and the ancillary tests did not yield any underlying pathology. An anesthetic blockade of her left external nasal nerve achieved a marked reduction of the number of episodes as well as their intensity.. External nasal neuralgia seems a specific neuralgia causing nasal pain. Anesthetic blockades of the external nasal nerve may be a valid treatment for this condition.

Topics: Aged; Anesthetics, Local; Bupivacaine; Female; Humans; Nerve Block; Neuralgia; Nose

A 66-year-old man came to the hospital with pain in the frontal left side of his upper jaw. Pressure along the left nostril could evoke a sharp pain, which radiated upwards. The patient had already consulted several specialists. After extended clinical and radiological investigation a mesiodens was found that gave pressure on the nasopalatine nerve.

Topics: Aged; Humans; Male; Maxillary Nerve; Neuralgia; Nose; Palate; Tooth, Supernumerary

We present four patients complaining of neuralgic pains across the nasal bridge following trauma, who were successfully treated by division of the external nasal nerve. We believe it is a useful treatment in selected cases.

Topics: Adult; Female; Fractures, Bone; Humans; Male; Middle Aged; Nasal Bone; Neuralgia; Nose

Pain about the bridge of the nose is often a diagnostic dilemma. There is a small but important recognizable subgroup who may, as a consequence of involvement of the external nasal nerve in nasal injury, exhibit neuralgic pain after a latent interval. Temporary relief by local anaesthesia is diagnostic and cure is possible by division of the anterior ethmoidal nerve. We present a series of six cases to illustrate this rare cause of facial pain.

Topics: Adolescent; Adult; Female; Humans; Male; Middle Aged; Neuralgia; Nose

Topics: Abscess; Anti-Bacterial Agents; Blepharoptosis; Blindness; Cellulitis; Conjunctiva; Cornea; Diagnosis, Differential; Edema; Ethmoid Bone; Eye Diseases; Eyelids; Face; Hypesthesia; Lacrimal Apparatus; Neuralgia; Nose; Ophthalmic Nerve; Ophthalmoplegia; Optic Neuritis; Orbit; Papilledema; Periosteum; Prednisone; Pupil; Sinus Thrombosis, Intracranial; Sinusitis

Topics: Evaluation Studies as Topic; Lacrimal Apparatus; Maxilla; Maxillary Nerve; Neuralgia; Nose; Parathyroid Neoplasms; Polyps

Topics: Denervation; Epistaxis; Humans; Maxillary Artery; Methods; Nasal Polyps; Neuralgia; Nose; Otorhinolaryngologic Diseases; Palate; Postoperative Complications; Sphenoid Bone; Surgical Instruments; Sutures

Topics: Aerosols; Caffeine; Diagnosis; Ergotamine; Headache; Humans; Migraine Disorders; Neuralgia; Nose; Vascular Diseases; Vascular Headaches

Topics: Cornea; Humans; Iritis; Neuralgia; Nose; Ophthalmic Nerve; Syndrome

Topics: Facial Injuries; Humans; Lidocaine; Neuralgia; Nose; Ophthalmic Nerve; Trigeminal Neuralgia

Topics: Humans; Neuralgia; Nose; Pain; Peripheral Nerve Injuries; Peripheral Nerves; Procaine

Topics: Calculi; Humans; Neuralgia; Nose; Nose Diseases; Tooth Extraction

Topics: Headache; Humans; Neuralgia; Nose

Topics: Headache; Humans; Neuralgia; Nose