Forehead pain

Introduction Most of the forehead pain is due to frontal sinusitis. Acute sinusitis remains 30 days after the onset of inflammation, known as chronic frontal sinusitis. Often under certain conditions, acute attacks are often accompanied by chronic ethmoid sinusitis. The forehead is swelled and the affected side is more obvious. If the frontal sinus drainage is blocked, headache may occur, there may be a reflex headache in the trigeminal nerve distribution area, nasal congestion is obvious, often heavier in the morning, and there may be persistent nasal congestion. Nasal secretions are purulent or purulent, more in the morning, often associated with head drainage. The sense of smell is diminished. If there is frontal osteomyelitis, the frontal purulent fistula can be formed, mostly located in the front wall of the frontal sinus and its bottom, where the bone wall contains bone marrow.

Cause

1. Acute frontal sinusitis is not treated or treated improperly, causing severe damage to the mucosa, loss of normal function, and becoming chronic inflammation.

2. Allergic frontal sinusitis, nasal frontal mucosal edema, and decreased cilia transport function, which hinders drainage during acute inflammation and becomes chronic inflammation.

3. The nasal septum is high, the middle turbinate is hypertrophy, the nasal polyps, and the nasal sinus complex is blocked.

4. Pneumatic injury, such as airborne downhill, swimming and diving, diving operations, can cause chronic infection of the frontal sinus.

5. Systemic factors such as reduced immune function, diabetes, malnutrition, vitamin deficiency, etc.

an examination

Related inspection

Front nose examination mammography X-ray examination CT plain scan

(a) anterior nasal examination

Mucosal congestion can be seen, and there is purulent secretion in front of the middle nasal passage. The pus of maxillary sinusitis is mostly in the lower back of the middle nasal passage. The sinusitis can be seen in the middle nasal passage and the olfactory fissure with purulent secretion, which can be identified.

(2) Head position test

When there is no purulent secretion in the anterior nasal examination, the middle turbinate and the middle nasal mucosa can be contracted with 1% ephedrine, and then the head is kept in the median position for 5 minutes. The nasal cavity is checked again to see if there is pus in the middle nasal passage. When accompanied by maxillary sinusitis, the maxillary sinus puncture can be performed first, the pus is removed, and then the head drainage is performed to determine the presence of frontal sinusitis.

(3) Frontal sinus X-ray film

The nasal frontal position and lateral position were taken, and the bilateral frontal sinus transmittance was compared to determine the lesion. The asymmetrical size of the frontal frontal sinus is normal and has nothing to do with the diagnosis of frontal sinusitis. A well-developed frontal sinus can have a bone septum, which is also normal.

(four) CT scan

Coronal and axial scans were used to show the size and extent of the frontal sinus, the condition of the anterior and posterior bone walls, and the absence of thickening in the mucosa of the sinus cavity.

Differential diagnosis

Should pay attention to the identification of the forehead headache. The same is the forehead pain, but the cause of the disease is different. Pay attention to the identification.

Forehead headache: The proliferation of pituitary adenomas in the forehead area that presses nearby tissues and causes forehead headaches.

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