[Sinonasal headache--reality or mis-diagnosis?]. / Cefaleea de cauza nazala--realitate sau diagnostic eronat?

UNLABELLED: Facial pain can be the presenting, and sometimes the only, complaint of many disorders that originate from cranial structures. One causes of facial pain/headache is sinusitis, in both its acute and its chronic presentation. Successful management of headache is preceded by the identification of an etiology and precise diagnosis. MATERIAL AND METHODS: A prospective study was carried out on a series of 71 patients treated in the ENT Department of Iasi "Sf. Spiridon" Hospital between January and august 2009 for pathology implying facial pain, headache, facial pressure, nasal obstruction, rhinorrhea. The therapy was medical and surgical and pursued nasal desobstruction, sinusal drainage and ventilation. Data regarding different parameters were analyzed pre and post therapy. RESULTS: After the proper treatment for each situation, the parameters analyzed improved significantly, although, in some cases the main accuses regarding the pain remained unchanged or slightly ameliorated. CONCLUSIONS: Depending on the clinical suspicion of the possible etiologies of facial pain and headache, the appropriate consultations should be made. For concerns of head and neck lesions or sinus-related headache, an otolaryngologist should be consulted. If a primary headache syndrome or a cranial neuralgia is of concern, the patient should be evaluated by a neurologist. Dentists and oral surgeons should be involved. In some cases, a psychiatry referral is appropriate. The surgical treatment can be effective if the pathology meets the criteria of sinonasal facial pain.

[The implications of cervical spine degenerative and traumatic diseases in the pathogenesis of cervical vertigo and hearing loss]. / Implicatiile bolilor degenerative si traumatice ale coloanei cervicale in geneza vertijului cervical si a hipoacuziei.

AIM: Cervical spine together with vestibular system,visual system and proprioceptive afferents plays an important role in mentaining balance. Spine damage causes distortions in transmitting informations to the brain,favoring vertigo. MATERIAL AND METHOD: The authors point out the occurrence of positional vertigo on 23 patients (20 patients with cervical spondylosis and 3 patients with cervical spine injury) due to blood flow disturbance through vertebral artery. RESULTS: The mechano-receptors located in intervertebral disks and cervical spine muscles are activated by column movement. Changes of blood flow in the vertebral and basilar arteries are showed up by cervical X-Rays, intracranial Doppler ultrasound or angio-MRI, an audiogram marking out the degree of hearing loss or tinnitus occurence. ENT complex treatment outcomes are analyzed and balneo-physio-therapy performed in order to improve vertigo and hearing loss. CONCLUSIONS: Stress beside muscle overload and cervical spine injures causes alteration in the ear blood-flow circulation that leads to hearing loss, vertigo and tinnitus. It emphasies the need for collaboration between balneologist and ENT specialist in solving balance and hearing disorders with cervicogenic cause.