Intranasal Xylocaine: a prognostic aid for pre-operative assessment of facial pain of nasal origin.

Many people with facial pain suggestive of sinus disease are ultimately proved, through extensive investigations, to have intranasal pathology without sinusitis. The middle turbinates in close proximity to other mucosal surfaces have been implicated as a possible cause of the rhinogenic pain. Surgical removal appears to provide relief in appropriately selected patient population. Pre-operative assessment to date has been mostly exclusional. Inference has been made to the efficacy of topical vasoconstrictive and combined vasoconstrictor-anesthetic agents as a diagnostic and prognostic aid for postoperative pain relief. Thirteen patients with middle turbinate hypertrophy, and symptoms suggestive of chronic rhinosinusitis were fully assessed clinically and radiographically. Significant sinus disease was ruled out. They were selected for middle turbinectomy with or without septoplasty. Topical Xylocaine was applied intranasally when patients were symptomatic. Postoperative follow-up suggests that the Xylocaine test may be a good prognostic aid for surgical outcome for craniofacial pain of apparent middle turbinate origin.