[Also consider sinusitis in facial pain: wisdown tooth, tumor, acute parotitis].

In numerous cases of head and facial pain, the underlying causes are found to be ENT problems. The most common cause of pain affecting the forehead and mid-facial region is acute sinusitis, in which the sphenoidal sinus is more commonly affected than previously assumed. Pain in the oral-facial region is largely due to disorders of the masticatory apparatus, but inflammatory diseases of the oral mucosa, abscesses or the so-called Eagle syndrome may also be involved. An accurate history and a clinical examination often points the physician in the right direction. To establish an accurate diagnosis, endoscopy of the upper airways and digestive system, together with ultrasonography, are usually required, followed, where necessary, by a radiological and NMR work-up, and puncture or biopsy. Provided that an accurate diagnosis has been established and multidisciplinary cooperation is available, the therapeutic options are usually effective.