DIAGNOSIS AND TREATMENT OF COMPLEX CASES OF SECONDARY OROFACIAL PAIN (CLINICAL OBSERVATION)
Orofacial pain is one of the most difficult problems in pain medicine. Rich innervated and closely localized anatomic structures can make diagnostic process extremely complicated. The main sources of orofacial pain can be intra- and extra-cranial structures, such as brainstem, scull bones, vertebrae, muscles, neurovasal groups, pharynx, laryngs etc. In some cases the reason of orofacial pain can be extracranial malignances (eg cancer). In this manuscript we describe clinical case with patient wit intensive pain in the right side of mandibula, along the mandibular nerve and full impossibility of mouth opening. There was a suspicion of possible extra-cranial neoplasm after examination. The pharyngeal cancer spreading on m.pterygopalatinum and mandibula was identified during instrumental diagnostics. Analgesic therapy was prescribed and chemotherapy is ongoing. Thus, careful examination and history taking are crucial factor of correct diagnostic and treatment of orofacial pain.