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Nose- and Sinus-related Neuralgia Syndromes: a Narrative Review with Proposed Diagnostic and Management Algorithm
Christos Tsilivigkos1, Marios Stavrakas2,3
1First Department of Otolaryngology, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece.
Maedica
|July 8, 2026
Summary
Nose- and sinus-related neuralgia syndromes (NSNS) are poorly defined, causing persistent facial pain. This review synthesizes literature and proposes a diagnostic and management algorithm for NSNS.
Area of Science:
- Otorhinolaryngology
- Neurology
- Pain Medicine
Background:
- Nose- and sinus-related neuralgia syndromes (NSNS) present as persistent pain linked to nasal and sinus nerves.
- Existing literature lacks a universally accepted definition and diagnostic criteria for NSNS.
- The complex nature of NSNS involves various overlapping syndromes and implicated nerves.
Purpose of the Study:
- To provide a narrative synthesis of studies on NSNS.
- To propose a structured algorithm for the diagnosis and management of NSNS.
Main Methods:
- A narrative review was conducted using structured database searches (Medline, Scopus) and manual searching.
- No restrictions were placed on publication dates.
Main Results:
- Numerous related syndromes with overlapping features have been reported since 1908.
- Diagnosis relies on thorough history, examination, endoscopy, imaging, and anesthetic tests.
- Management includes conservative and surgical options.
Conclusions:
- A significant evidence gap exists due to a lack of high-quality studies (RCTs, prospective comparative studies).
- A practice-oriented diagnostic and management algorithm for NSNS is proposed.
- Prospective controlled studies are essential for validating and refining NSNS recommendations.
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