SLUDER’S NEURALGIA //CORRECTION OF SEPTAL SPUR WITH CAUDAL DISLOCATION скачать в хорошем качестве

SLUDER’S NEURALGIA //CORRECTION OF SEPTAL SPUR WITH CAUDAL DISLOCATION

Case Presentation Patient Profile • Age/Sex: 25-year-old male • Chief Complaint: • Recurrent right-sided facial pain and headache for several months • Nasal obstruction, predominantly right-sided History of Present Illness • Facial Pain: • Sharp, shooting, deep-seated pain around the right eye, cheek, and upper jaw. • Episodes last minutes to hours, often triggered by cold air, nasal congestion, or exertion. • Associated Symptoms: • Nasal obstruction more on the right side. • No epistaxis, anosmia, or purulent nasal discharge. • No history of migraine or trigeminal neuralgia. Examination Anterior Rhinoscopy • Right-sided septal spur impinging on the lateral nasal wall. • Anterior caudal dislocation of the septum to the right. Endoscopic Findings • Contact point between septal spur and middle turbinate on the right side. • Left caudal septal dislocation visible intraoperatively. Neurological Exam • Normal, except tenderness over infraorbital region. Investigations • Diagnostic Nasal Endoscopy → Confirmed septal spur and mucosal contact point. • CT PNS → Deviated nasal septum with right anterior caudal dislocation; no sinus disease. Diagnosis Sluder’s Neuralgia secondary to right-sided septal spur with anterior caudal septal dislocation. Management Surgical Plan • Endoscopic Septoplasty: • Removal of right-sided septal spur. • Correction of anterior caudal dislocation. • Preservation of septal support. • Intraoperative Findings: • Right septal spur impinging on lateral nasal wall. • Left-sided caudal dislocation corrected. Postoperative Care • Nasal packing for 24–48 hours. • Saline irrigations, antibiotics, and analgesics. • Avoid nose blowing and trauma. Outcome • Significant reduction in headache and facial pain within weeks. • Nasal airway markedly improved. Discussion • Sluder’s neuralgia (sphenopalatine neuralgia) often arises due to septal spurs or mucosal contact points irritating branches of the sphenopalatine ganglion. • Endoscopic septoplasty is effective when neuralgia is secondary to an anatomical contact point. • Success rates are high (~70–80%) if the neuralgia is contact-point mediated. #anatomy #biology #ear #ent #nose #nosebleed #otolaryngology #science #throathealth #tonsils