Head

The head (with the exception of the brain and the spine) is part of the speciality of otolaryngology head and neck surgery. There are ear nose and throat specialists who specialize just in facial plastic surgery. I have been trained in plastic surgery techniques in incision design to hide or minimize the appearance of scar.

There are many types of growths and cysts of the head and face that should be biopsied. In some cases this can be done in the office.

Facial Pain

Facial pain can have many causes including sinusitis, neuralgias, headache syndromes, and temporomandibular joint syndrome. Consultation with an Ears, Nose, and Throat specialist may assist with diagnosis.

Facial Paralysis (Bell's Palsy)

The Facial nerve is the nerve that controls the movement of the facial muscles. It emerges just beneath the ear and separates into five branches as it runs forward to the muscles of the face. Weakness or drooping of one side of the face is a problem that can occur spontaneously without warning. This condition is called Bell's Palsy. We believe that it is caused by a virus getting into the Facial Nerve. This is a condition which requires immediate evaluation by an Ears, Nose, and Throat specialist and likely treatment with anti-inflammatory medications.

If the virus involved is the chickenpox/shingles virus, it is then called Ramsey Hunt syndrome. In this case, there would be pox on the face and ear and facial pain, in addition to the facial paralysis Ramsey Hunt syndrome should also be treated with anti-viral medications in addition to anti-inflammatory medications.

In other cases, other conditions, including neurologic diseases, tumors, and other infectious/inflammatory diseases may cause facial paralysis. As mentioned before, it is of utmost importance to have an immediate evaluation by an ears, nose, and throat physician to help identify or rule out these other causes.

Facial Trauma

Trauma to the face due to a fall or a sports injury is common. Frequently the nose can be broken. Sometimes other bones of the face are broken, particularly the ones that support the eye (The orbital floor and rim). If these are fractured then surgical repair is necessary with implants to hold the bones together and support the eye. This is called Open Reduction and Internal Fixation of a fracture. Fractures of the jaw bone (mandible) are usually seen by an Oral Surgeon.

Facial pain can have many causes including sinusitis, neuralgias, headache syndromes, and temporomandibular joint syndrome. Consultation with an Ears, Nose, and Throat specialist may assist with diagnosis.

Temporomandibular Joint Syndrome

The temporomandibular joint (TMJ) is the joint where the mandible (jaw bone) attaches to the skull. It is the hinge that allows the mandible to open and close during chewing, breathing, and speaking. This joint is located directly in front of the ear, and you can feel it if you place your finger directly in front of the ear, (behind the sideburns) and open and close your mouth. Some people may feel some clicking there.

The TMJ is a joint like your knee or your elbow and like these joints it is at risk for an entire range of injuries. These range from a soft tissue injury (sprain) involving the muscles, tendons, and ligaments to degenerative problems where the cartilage of the joint is eroded leading to bone rubbing against bone with the resulting pain and limitation in movement.

This is a common cause of facial or ear pain. In the early stages it can be treated with a soft diet and anti-inflammatory medications. If symptoms persist an MRI can determine if degenerative disease is present. In these cases an Oral Surgery evaluation is indicated.

Trigeminal Neuralgia

Neuralgia means inflammation of the nerve. The Trigeminal nerve carries stimulation of touch, pressure, and pain from the face to the brain where the corresponding sensations are detected. Trigeminal Neuralgia is a pain syndrome where there is inflammation of the Trigeminal nerve producing pain in the face which does not have any other cause. To make this diagnosis all other possible causes for the pain have to be ruled out.