Oxford Handbook of Oral and Maxillofacial Surgery by Cascarini Luke; Schilling Clare; Gurney Ben

Author:Cascarini, Luke; Schilling, Clare; Gurney, Ben
Language: eng
Format: epub
Publisher: Oxford University Press, Incorporated
Published: 2018-03-15T00:00:00+00:00

Miscellaneous conditions in the clinic

Sinusitis

This is an important differential of facial pain. It is often worse on leaning forward (e.g. climbing stairs or wearing high heels). There may be post-nasal drip and purulent discharge from the nose.

Imaging is not usually helpful—fluid in the sinus and antral polyps are common and do not correlate well with symptoms. Rule out odontogenic and oncological causes; then refer to ENT.

Epidermoid and pilar cysts

These are very common (old term, sebaceous cyst) and are often found on the face or scalp where they can be multiple. Epidermoid cysts are from a superficial layer of the skin and pilar cysts from the hair follicle, but in practice it is almost impossible to distinguish the two. The lesions are firm, well circumscribed, and tethered to the skin via a punctum (differential diagnosis lipoma, neurofibroma, turban tumour, etc.). When a cyst is infected it should be treated as an abscess, but formal excision should be arranged after the infection has cleared up.

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