Nose- and Sinus-related Neuralgia Syndromes: a Narrative Review with Proposed Diagnostic and Management Algorithm
Abstract
Objective: Nose- and sinus-related neuralgia syndromes (NSNS) constitute a constellation of clinical entities characterized by persistent pain in the distribution of nerves from the nasal cavity and paranasal sinuses. Various characterizations and management approaches have been reported in the literature, yet no universally accepted definition exists. The aim of this study is to provide a narrative synthesis of relevant studies and to propose a structured algorithm for the diagnosis and management of this intriguing clinical entity.
Materials and methods: A narrative review informed by a structured database search was conducted using Medline (via PubMed), Scopus and manual searching, with no restrictions on publication date.
Results: Since Sluder's first description in 1908, a number of related syndromes have been reported in the literature, each with partially overlapping clinical features and diagnostic criteria, including anterior ethmoidal nerve syndrome, anterior ethmoidal neuralgia, sphenopalatine neuralgia, syndrome of the olfactory fissure, nasociliary neuralgia (Charlin's syndrome), collectively reflecting the complex and ambiguous nature of these disorders. While the anterior ethmoidal nerve is central to the syndrome, other nerves innervating the lateral nasal wall and nasal pyramid skin are also implicated in the associated headache. Complex pathophysiological mechanisms contribute to the chronic pain. Clinically, the syndrome is characterized by the absence of…
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