Facial Pains

Pain in the face can arise from the sinuses, but other rare causes include migraine, neuralgia, jaw joint problems and other possibilities. An accurate description of the features of the pain often provides important clues.

Diagnostics

CT scan

Why?

Computed tomography (CT) is a medical imaging method using X-ray tomography created by computer processing. It provides important diagnostic information in various anatomical planes. The main advantage over MRI scanning is that it demonstrates bone as well as soft tissue features. A temporal bone CT scan will therefore show details of sinus and jaw bone problems. Airway problems and head and neck cancers are well demonstrated on CT scanning.

How?

The scanning technique involves lying still with the head in a medical “hair-dryer” capsule for approximately 20 minutes. It is a completely painless procedure.

MRI scan

Why?

Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to study internal soft tissue structures in detail. It provides good contrast between the different types of tissue, which is a major advantage over CT. MRI does not use ionising radiation unlike CT or traditional X-rays. Instead it uses a powerful magnetic field to align tissue atoms, and then uses radiofrequency fields to change and record their alignment. This scanned information is then used to construct images of specific parts of the body. The commonest indication for an MRI scan is parotid or tongue tumours and sinus or skull base tumours.

How?

The patient lies still on a couch with their head in a metal tube. Some patients find this enclosed experience unpleasant, which has resulted in the development of so-called “open scanners”.

Flexible Nasal Endoscopy

Why?

Flexible nasal endoscopy is an examination of the nasal air passages, the space behind the nose and the throat using a small telescope. This test can identify the cause of voice problems, swallowing problems, reflux changes, and Eustachian tube problems. It may also be used for neck lumps to check for tumours in the throat and for thyroid problems to examine vocal cord movement.

How?

The doctor may or may not use a local anaesthetic which is sprayed in the nose. This makes the nose and the back of the throat numb. The telescope is then placed into the nose and then passed into the back of the throat. Most people do not experience discomfort from the procedure. If a local anaesthetic is used, the numbness will wear off after 30 minutes or so. Please note that you should not eat or drink for at least 30 minutes, and you should not consume anything hot for at least one hour.