Post-Traumatic External Nasal Pain Syndrome (a Trigeminal Based Pain Disorder)

Post-Traumatic External Nasal Pain Syndrome (a Trigeminal Based Pain Disorder)
Headache: The Journal of Head and Face Pain
Volume 49 Issue 8, Pages 1223 - 1228
Todd Rozen, MD
From the Michigan Head Pain & Neurological Institute – Neurology, Ann Arbor, MI, USA.
Correspondence to T. Rozen, Michigan Head Pain & Neurological Institute, 3120 Professional Drive, Ann Arbor, MI 48104, USA.
Conflict of Interest: None

Copyright Copyright © 2009 American Headache Society
KEYWORDS
trigeminal nerve • facial pain • headache • nasal pain • sphenopalatine ganglion
(Headache 2009;49:1223-1228)

ABSTRACT
Little has been written about persistent external nasal pain after injury to the nose in the neurologic or headache literature. In clinical practice, this can be a disabling and treatment refractory condition. The external portion of the nose is highly innervated by branches of the ophthalmic and maxillary divisions of the trigeminal nerve including the nasociliary nerve, external nasal nerve, infratrochlear nerve, anterior ethmoidal nerve, and infraorbital nerve. As these nerves are located on the external portion of the nose just deep enough to the skin they can be easily traumatized with any impact to the nose.

Four patients with what is termed the post-traumatic external nasal pain syndrome are reported in this paper, describing the clinical presentation of the disorder and providing treatment options. Post-traumatic external nasal pain syndrome appears to be a novel form of trigeminal-based pain not previously reported in the neurologic literature.


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Accepted for publication May 18, 2009.

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1526-4610.2009.01485.x About DOI