Progressive Unilateral Nasal Congestion, Facial Pain, and Vision Change in an Immunocompetent Patient

Background Cystic fibrosis (CF) is a multisystem disease that involves the upper airways with chronic rhinosinusitis (CRS) causing nasal congestion, rhinorrhea, mouth breathing, facial pain, and olfactory dysfunction. Twelve percent to 71% of CF patients report smelling alterations with an impact on nutrition and quality of life. Objectives The goal was to study olfaction performance in CF patients with CRS that worsens quality of life. Methods A total of 121 subjects were enrolled in this study. Seventy-one had CF and underwent ear, nose, and throat evaluation with nasal endoscopy, sinonasal outcome test 22 (SNOT-22), visual analog scale (VAS), and “Sniffin’ Sticks.” Fifty subjects were age-matched with healthy controls. Results All 71 CF patients were affected by CRS; 59 of 71 (83.1%) had CRS without nasal polyps and 12 of 71 (16.9%) had CRS with early nasal polyps. None of the 50 controls had CRS. Total SNOTT-22 mean values in the 71 CF patients were 38.10 ± 21.08 points. If considering only the 59 CF patients without nasal polyps, the SNOTT-22 mean value was 36.76 ± 21.52 points. Moreover, based on the VAS scores, the degree of nasal symptoms was classified as mild for facial pain, smell alteration, nasal discharge, and sneezing and resulted in moderate symptoms for nasal blockage and headache. Among the CF patients, 55 of 71 (76.5%) declared to be normosmic, while the smelling ability assessed by “Sniffin’ Sticks” showed that only 4 of 71 (5.63%) were normosmic, 58 (81.69%) were hyposmic, and 9 (12.68%) were anosmic. In the controls, 41(82%) were normosmic, 9 (18%) were hyposmic, and none were reported to be anosmic ( P < .001). Conclusions We confirm that most CF patients have a relevant olfactory impairment, although only a low percentage declares such alteration. A careful evaluation with simple and rapid tests helps to select the patients who may benefit from specific therapies.

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GAMBARAN DERAJAT KEPARAHAN GEJALA PASIEN RINOSINUSITIS KRONIK DI RSUD DR. SOETOMO SURABAYA

Care Jurnal Ilmiah Ilmu Kesehatan ◽

10.33366/jc.v8i2.1666 ◽

2020 ◽

Vol 8 (2) ◽

pp. 235

Author(s):

Anggita Putri Samara ◽

Budi Sutikno ◽

Reny I’tishom

Keyword(s):

Risk Factor ◽

Observational Study ◽

Medical Record ◽

Nasal Obstruction ◽

Facial Pain ◽

Nasal Congestion ◽

The Other ◽

Nasal Discharge ◽

Analog Scale ◽

Nasal Inflammation

Chronic rhinosinusitis (CRS) is a sinus paranasal and nasal inflammation marked with two or more symptoms, nasal congestion or nasal discharge and the other symptom like facial pain and reduced smell may present. This symptom occur >12 weeks. One of the parameter for symptom’s severity assessmentis using Visual Analog Scale (VAS) that can be classified as mild (0-3), moderate (4-7), dan severe (8-10). This study was a observational study by assessing patient’s medical record at SMF THT-KL RSUD Dr. Soetomo and analyzed descriptively. 43 patients were enrolled to study (28 male and 15 female), most of them were between age 36-45 years old (25,58%). Most of the patient’s symptom’s severity in general, nasal obstruction, nasal discharge, facial pain, and reduced smell were moderate (65,11%), moderate (58,13%), mild (41,86%), mild (58,13%), mild (62,79%) respectively. Most of the patients had risk factor (62,79%), and the most of the patient’s risk factor were allergy. Most of the CRS patients in this study were male, 36-45 years old, with the general symptom’s severity moderate, moderate nasal obstruction, mild nasal discharge, mild facial pain, mild reduced smell, and had allergy.

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Pathophysiology and management of gustatory rhinitis

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v50i2.404 ◽

2021 ◽

Vol 50 (2) ◽

pp. 183

Author(s):

Shally Adhina Putri ◽

Nina Irawati

Keyword(s):

Literature Review ◽

Nerve Stimulation ◽

Facial Pain ◽

Neurogenic Inflammation ◽

Nasal Congestion ◽

Sensory Nerve ◽

Topical Steroid ◽

Initial Management ◽

Single Drug ◽

Stimulation Of

ABSTRACTBackground: Gustatory rhinitis is a syndrome that causes symptoms of annoying rhinorrhea, occurring immediately after consuming solid or liquid foods which are hot and /or spicy. Usually starts within a few minutes after the ingestion of the foods involved, and is not associated with itching, sneezing, nasal congestion or facial pain. Purpose: To discuss the pathophysiology and proper management of gustatory rhinitis. Literature Review: Recent studies suggest that gustatory rhinitis is likely associated with phenomenon of neurogenic inflammation. The ingestion of spicy foods caused the stimulation of trigeminal sensory nerve endings located in the upper part of the aerodigestive track. Sensory nerve stimulation seems to be correlated with an activation of post ganglionic cholinergic muscarinic parasympathetic fibers and sensitive to atropine. Conclusion: The initial management of gustatory rhinitis is avoiding the trigger foods. Using combination of topical steroid and anticholinergic intranasal had been proven more effective to treat the rhinorrhea caused by gustatory rhinitis than administration of single drug. ABSTRAKLatar belakang: Rinitis gustatori adalah sindroma yang menimbulkan gejala rinore yang mengganggu, sesaat setelah mengonsumsi makanan padat atau cair, yang bersifat pedas dan/atau berempah. Biasanya dimulai dalam beberapa menit setelah menelan makanan tersebut, dan tidak disertai dengan gatal, bersin, hidung tersumbat atau nyeri wajah. Tujuan: Untuk membahas patofisiologi dan tatalaksana yang tepat pada rinitis gustatori. Tinjauan Pustaka: Sejumlah studi terbaru mendapatkan rinitis gustatori berkaitan dengan fenomena inflamasi neurogenik. Proses menelan makanan pedas dapat menyebabkan stimulasi ujung saraf sensorik trigeminal yang terletak di jalur aerodigestif bagian atas. Stimulasi saraf sensorik tersebut berkaitan dengan pengaktifan serabut saraf parasimpatik muskarinik kolinergik post ganglion yang sensitif terhadap atropin. Kesimpulan: Tatalaksana awal yang dapat dilakukan untuk mengatasi rinitis gustatori adalah menghindari makanan pemicu. Kombinasi penggunaan antikolinergik intranasal dan steroid topikal, secara profilaksis atau sebagai terapi telah terbukti lebih efektif untuk mengatasi rinore akibat rinitis gustatori dibandingkan pemberian masing- masing obat tersendiri.

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Pediatric Invasive Fungal Rhinosinusitis in Immunocompromised Children With Cancer

Otolaryngology ◽

10.1016/j.otohns.2005.04.014 ◽

2005 ◽

Vol 133 (3) ◽

pp. 411-416 ◽

Cited By ~ 47

Author(s):

Albert H. Park ◽

Harlan R. Muntz ◽

Marshall E. Smith ◽

Zeinab Afify ◽

Theodore Pysher ◽

...

Keyword(s):

Facial Pain ◽

Nasal Congestion ◽

Lymphoblastic Leukemia ◽

Retrospective Chart Review ◽

Myelogenous Leukemia ◽

Immunocompromised Patients ◽

Children With Cancer ◽

Endoscopic Findings ◽

Fungal Rhinosinusitis ◽

Invasive Fungal Rhinosinusitis

OBJECTIVES: 1) To determine the factors that predispose towards invasive fungal rhinosinusitis (FS) in immunocompromised children with cancer, and 2) to propose practice guidelines for management of pediatric FS in immunocompromised patients. METHODS: Retrospective chart review of 9 patients who developed invasive FS compared to 8 patients who did not develop invasive FS during the study period. Presenting signs and symptoms, nasal endoscopic findings, radiographs, laboratory studies, histologic and microscopic samples, and outcomes were compared. RESULTS: Seventeen consecutive pediatric immunocompromised patients with hematologic and lymphoid neoplasms underwent nasal endoscopy and biopsy for possible FS. Nine patients were diagnosed with 10 episodes of FS; 1 patient developed FS with different organisms on 2 separate occasions separated by 6 months; 8 patients were not diagnosed with FS. Eight patients had acute myelogenous leukemia (AML); 6 patients had acute lymphoblastic leukemia (ALL); 1 patient had Burkitt's lymphoma, 1 patient had undifferentiated leukemia; and 1 patient had biphenotypic acute leukemia. All patients with FS had an absolute neutrophil count (ANC) 600 or less (range 0-600). All patients with FS had either persistent fevers or sinus symptoms (facial pain, nasal congestion, rhinorrhea). Sinus CT scans were abnormal in all patients with FS and without FS. Two patients with FS had maxillary sinus retention cysts. Operative endoscopic findings were helpful diagnostically when necrosis or ulceration was found. All patients in the non-FS group normalized their ANCs; 2 of the 9 patients in the FS group did not normalize their ANC. These 2 patients died from disseminated FS or from complications due to their immunosuppression. CONCLUSION/SIGNIFICANCE: All patients with FS had either persistent fevers or symptoms localized to the sinuses (facial pain, nasal congestion, or rhinorrhea). Endoscopic examination was helpful when necrosis was detected. We recommend directed biopsies of suspicious lesions, the middle and inferior turbinate, in immunocompromised, neutropenic pediatric patients with cancer who present with either persistent fevers or localizing symptoms to the sinuses. We favor the use of “rush” biopsies over frozen sections because of the better-quality sections and ability to perform appropriate stains.

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S251 – Facial Symptoms Related to Allergic Rhinitis in U.S. Children

Otolaryngology ◽

10.1016/j.otohns.2008.05.427 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P159-P159

Author(s):

M Jennifer Derebery ◽

Eli O Meltzer ◽

John Boyle

Keyword(s):

Allergic Rhinitis ◽

National Survey ◽

Facial Pain ◽

Nasal Congestion ◽

Fold Increase ◽

Nasal Allergy ◽

Older Children

Objectives In addition to general symptoms related to nasal congestion, common secondary symptoms of allergic rhinitis (AR) include headache, facial pain/pressure, and ear pain/pressure. The prevalence of secondary AR symptoms in U.S. children is described herein. Methods The prevalence of headache, facial pain/pressure, and ear pain/pressure in children with and without AR was studied in Pediatric Allergies in America, a national survey of parents of 500 children with current symptoms of nasal allergies and 504 children without nasal allergies (aged 4 to 17 years) among 35,757 U.S. households. Children aged 10 to 17 years were also interviewed, in addition to their parents. Results Parents report that the occurrence of headaches (55% vs 18%), facial pain/pressure (29% vs 3%), and ear pain/pressure (24% vs 5%) is more frequent in children with AR, compared with those without, respectively. These figures represent an approximately 3-fold increase in headaches, nearly a 10-fold increase in facial pain/pressure, and an approximately 5-fold increase in ear pain/pressure in children suffering from presumed AR, compared with children without AR. Furthermore, headache (59%; 63%), facial pain/pressure (53%; 54%), and ear pain/pressure (56%; 44%) were rated moderately or extremely bothersome by more than half of parents and older children (aged 10 to 17 years) who reported experiencing these symptoms, respectively. Conclusions The Pediatric Allergies in America survey suggests that children with presumed AR may suffer significant headache, facial pain/pressure, and ear pain/pressure from nasal allergy symptoms that are not shared by children without nasal allergies.

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Correlations between symptoms, nasal endoscopy and computed tomography findings in patients with chronic rhinosinusitis without nasal polyps

Vojnosanitetski pregled ◽

10.2298/vsp171218044s ◽

2020 ◽

Vol 77 (1) ◽

pp. 41-46

Author(s):

Slobodan Savovic ◽

Natasa Dragnic ◽

Vladimir Kljajic ◽

Ljiljana Jovancevic ◽

Maja Buljcik-Cupic ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Facial Pain ◽

Nasal Polyps ◽

Nasal Congestion ◽

Endoscopic Examination ◽

Nasal Endoscopy ◽

Nasal Discharge ◽

Strongly Correlated ◽

Moderate Correlation ◽

Severity Of The Disease

Background/Aim. Chronic rhinosinusitis (CRS) is one of the most common chronic conditions that is diagnosed on the basis of the condition symptoms, nasal endoscopy and computed tomograhpy (CT) of the nose and paranasal sinuses. There are two forms of CRS: CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). The aim of this paper was to determine if there is a correlation between the symptoms, nasal endoscopy and CT in patients with CRSsNP. Methods. The study included 110 patients with CRSsNP. The intensity of the symptoms assessed on the visual analogue scale (VAS) and the condition of nasal mucosa and the presence of nasal secretion was estimated by endoscopic examination of the nose while CT was used to determine the Lund-Mackay (LM) score values. Pearson?s coefficient of correlation was used for statistic data processing. Results. The severity of the disease as a whole (r = 0.509) and nasal discharge (r = 0.562) moderately correlated with CT. Nasal congestion (r = 0.354) and the reduction of loss of smell (r = 0.324) mildly correlated with CT, while facial pain/pressure (r = 0.218) had a very weak correlation with CT. The severity of the disease as a whole (r = 0.717) and nasal discharge (r = 0.821) strongly correlated with nasal endoscopy. Nasal congestion (r = 0.525) had a moderate correlation with nasal endoscopy while facial pain/pressure (r = 0.345) and the reduction of the loss of smell (r= 0.394) had a mild correlation with nasal endoscopy. A moderate correlation was found between nasal endoscopy and CT (r = 0.630). Conclusion. The severity of the disease as a whole and nasal discharge have more significant correlations both with nasal endoscopy and CT in relation to the correlations between other symptoms and nasal endoscopy, as well as CT. More significant correlations between the symptoms and nasal endoscopy in relation to the correlations between the symptoms and CT and the existence of a moderate correlation between nasal endoscopy and CT, enable a lesser use of CT diagnostics and only in precisely defined situatiations.

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Sinusitis in Children

Journal of Pediatrics & Neonatal Biology ◽

10.33140/jpnb.05.04.07 ◽

2020 ◽

Vol 5 (4) ◽

Keyword(s):

Facial Pain ◽

Chronic Sinusitis ◽

Nasal Congestion ◽

Nasal Secretion ◽

Common Disease ◽

Significant Morbidity ◽

Periorbital Edema ◽

Infectious Origin ◽

Facial Area ◽

Bad Breath

Sinusitis is a common disease in childhood and puberty with significant morbidity and the potential for serious complications. There are two types of acute sinusitis: viral and bacterial. Viral sinusitis develops during a cold. Some children with certain predisposing diseases may develop forms of chronic sinusitis, which is usually not of infectious origin. Children and adolescents may have nonspecific symptoms: fever, nasal congestion, nasal secretion. Less common difficulties include bad breath, reduction sense of smell, and periorbital edema. Headaches and facial pain are rare in children. The most common symptoms are headache, tenderness in the facial area and a stuffy nose.

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Cavernous sinus syndrome due to rhino-orbital-cerebral mucormycosis

Radiologia Brasileira ◽

10.1590/s0100-39842013000300016 ◽

2013 ◽

Vol 46 (3) ◽

pp. 187-189

Author(s):

Vagner Moysés Vilela ◽

Hélder de Castro Marques ◽

Rodolfo Elias Diniz da Silva Carvalho ◽

Erika Zavelinske ◽

André Geraldo da Silva Duque ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Facial Pain ◽

Present Report ◽

Nasal Congestion ◽

Cranial Nerves ◽

Resonance Imaging ◽

Cavernous Sinus Syndrome ◽

Peripheral Enhancement

The present report describes the case of a 43-year-old diabetic patient with facial pain, protruding eyes, nasal congestion and decreased right vision (involvement of the ipsilateral cranial nerves III, IV and V). Computed tomography showed diffuse sinusitis at right, cribriform plate erosion and presence of a hypodense collection in the frontal lobe with peripheral enhancement. Magnetic resonance imaging confirmed the presence of a cerebral abscess. Samples were collected from the lesion, confirming hyphae compatible with mucormycosis.

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Patient with nasal congestion, purulent discharge, facial pain and hyposmia

Cytopathology ◽

10.1111/cyt.12875 ◽

2020 ◽

Vol 31 (6) ◽

pp. 624-626

Author(s):

Rafael Martínez‐Girón ◽

Cristina Martínez‐Torre ◽

Santiago Martínez‐Torre

Keyword(s):

Facial Pain ◽

Nasal Congestion ◽

Purulent Discharge

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Application of herbal means "Sinudafen" in complex treatment of acute rhinosinusitis

OTORHINOLARYNGOLOGY 2-3(2) 2019 - OTORHINOLARYNGOLOGY ◽

10.37219/2528-8253-2021-1-68 ◽

2021 ◽

pp. 68-73

Author(s):

Grigory I, Garyuk ◽

Oleg G. Garyuk

Keyword(s):

Antibacterial Therapy ◽

Facial Pain ◽

Nasal Congestion ◽

Statistical Significance ◽

Objective Assessment ◽

Secretory Cells ◽

Upper Respiratory Tract ◽

Complex Treatment ◽

Nasal Breathing ◽

Acute Rhinosinusitis

Relevance: The urgency of the problem of treatment of acute viral rhinosinusitis stems from the frequency of the incidence of this pathology and the use of various treatments, among which the greatest concern is the unwarranted appointment of antibacterial therapy. The combination of Sinudafen extracts allows to normalize the secretion and viscosity of mucus by stimulating the secretory cells of the mucous membrane of the upper respiratory tract, reduce swelling in the area around the sinuses and restore drainage, detect anti-inflammatory, immunostimulatory, antiviral and antiviral effects. The purpose of the study was to study the effectiveness of treatment of acute rhinosinusitis with the use of herbal Sinudafen. Results and discussion: The study involved 94 patients with acute rhinosinusitis. Some patients with appropriate symptoms had to be prescribed antibacterial therapy. Thus, according to the results of the appointment of antibacterial therapy, we obtained a distribution when calculating the statistical significance of the results of such a distribution P = 0.043 (<0.05). That is, the reduction in the number of prescriptions of antibacterial therapy in patients where Sinudafen was used in the treatment was statistically significant. Objective assessment of the degree of dysfunction of nasal breathing was performed using anterior active rhinomanometry (PARM). Assessment of subjective sensations was performed using a visual - analog scale for four main symptoms of the disease: nasal congestion, rhinorrhea, facial pain, loss of smell. Conclusions: The use of Sinudafen in the complex treatment of acute rhinosinusitis accelerates the dynamics of the disappearance of its symptoms such as rhinorrhea and facial pain. The use of Sinudafen in the treatment of acute rhinosinusitis significantly reduces the frequency of antibacterial therapy.

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