Pain in the cheekbone is observed with traumatic injuries, osteomyelitis, neuralgia, bruxism, myofascial syndrome, dental and otolaryngological diseases, some types of headache and facial pain. It can be dull, sharp, short-term, long-lasting, aching, bursting, twitching, shooting. Often occurs due to irradiation, combined with pain in neighboring anatomical structures. The cause of the symptom is established according to the survey, dental and otolaryngological examination, additional studies. Therapeutic measures include pain relief, etiopathogenetic therapy, surgical interventions.
The most common injury to the zygomatic region is a bruise. Occurs in fights, less often - when falling or hitting a hard surface (for example, a door jamb). The pain is moderate and subsides quickly. Local edema and hyperemia are observed, abrasions are possible. Opening the mouth is not difficult, speech is not changed. All symptoms disappear within a few days or 1-2 weeks.
With a fracture of the zygomatic bone, the pain is very acute, intense. Bruising is detected, swelling quickly spreads to the adjacent parts of the face. Pain is noted when trying to open the mouth, numbness of the cheek, wing of the nose and upper lip, sometimes diplopia. If the integrity of the maxillary sinus is violated, nosebleeds develop, subcutaneous emphysema is possible. When the fragments are displaced, a step is felt in the cheekbone area.
The zygomatic bone is involved in the formation of the wall of the orbit. If the bone wall of the orbit is damaged, along with the symptoms listed above, limited mobility of the eyeball, visual impairment, subcutaneous emphysema, exophthalmos or endophthalmos are found. Orbital injuries can also be accompanied by double vision, strabismus, and in severe cases, blindness.
Severe jerking, throbbing pain in the cheekbone may be due to post-traumatic osteomyelitis. The disease develops after an open fracture, surgery on the zygomatic bone and nearby tissues. The wound becomes edematous, its edges turn red. Suppuration, intoxication, general hyperthermia are observed. After opening the abscess, pain and inflammation subside, a fistulous tract forms in the wound area.
Burning, shooting pains in the cheekbone, resembling an electric discharge, are characteristic of the defeat of the second branch of the trigeminal nerve. Pain sensations spread from the side of the face to the center, capture the upper part of the cheek, upper jaw, upper lip, nasal mucosa. Attacks of neuralgia last up to 2 minutes, are repeated many times, forcing patients to freeze in place.
In patients with ganglionitis of the pterygopalatine ganglion, intense prosopalgia in the zone of the cheekbone, eye, hard palate and base of the nose prevails, but the symptom is never clearly localized, since a large number of nerve branches cause the spread of pain to neighboring parts of the face, gums, teeth, sometimes the back of the head, neck , Temple And Ear. A distinctive feature of the pathology is pronounced vegetative symptoms: lacrimation, hypersalivation, hyperemia and swelling of half of the face.
Sometimes the cause of radiating pain in the cheekbone is ganglionitis of the geniculate node, although pain in the ear with irradiation to the back of the head, face and neck is more typical for this variant of ganglioneuritis. Pain sensations are paroxysmal in nature, in some patients they are combined with neuritis of the facial nerve.
Pain in the cheekbone
In patients with bruxism, bilateral aching pain in the cheekbones is due to overexertion of the masticatory muscles during repeated nocturnal episodes of teeth grinding. Drowsiness, headache and toothache, soreness in the jaw area are possible. Chips, cracks, hyperesthesia and pathological abrasion of teeth are often observed. With myofascial syndrome, pains increase gradually, are the result of constant muscle tension when the jaws are clenched against the background of overloads, stressful situations, and neurotic disorders.
Irradiation to the cheekbone is noted with the defeat of the upper premolars and molars on the corresponding side. In some cases, the pain in the cheekbone is so pronounced that it prevails over pain in the area of the teeth. A symptom can be observed after tooth extraction, with alveolitis, pulpitis, periodontitis. With deep caries, it does not spontaneously occur, it is associated with the ingress of food into the carious cavity.
The maxillary sinus is located in the body of the maxillary bone. Its wall borders on the zygomatic bone, which causes pain to spread to the cheekbone when this sinus is affected. The symptom appears with the following diseases:
In addition, acute arching pain in the cheekbone is typical for one of the orbital complications of sinusitis - orbital osteoperiostitis. The spread of the inflammatory process to the lower outer wall of the orbit causes the involvement of the zygomatic bone. Along with the symptoms of sinusitis, significant edema of the periorbital tissue, exophthalmos, displacement and limitation of eye mobility are found.
Headaches with possible irradiation to the cheekbone are observed in diseases with a completely unexplained etiology - cluster headache and paroxysmal hemicrania. Sometimes the epicenter of pain in the cheekbone with spread to other areas is noted with atypical facial pain. Pain syndrome of psychogenic origin against the background of stress or overwork is formed in emotionally unstable, suspicious people. In some cases, the symptom is found in patients with hypochondria, occurs with delusional and hallucinatory disorders.
The cause of pain in the cheekbone is determined by the maxillofacial surgeon. According to the indications, the patient is referred to an otolaryngologist, neurologist, and other specialists. During the survey, the time and circumstances of the onset of the symptom, the dynamics of its development, the presence of other manifestations indicating the nature and localization of the pathological process are established. As part of a dental examination, dental diseases are excluded.
When determining the etiology of neuropathic pain, an important role is played by the study of trigger points, special tests (for example, with dikain and adrenaline in ganglionitis of the pterygopalatine ganglion). To clarify the diagnosis, the following procedures are prescribed:
Dental treatment
Analgesics are used to eliminate intense pain syndrome. The list of other therapeutic measures is determined depending on the characteristics of the pathological process:
It is possible to carry out the following surgical interventions: