Atypical Facial Pain Secondary to an Unusual Iatrogenic Endonasal “Contact Point”

Dear Editor, Headache and facial pain are common complaints in clinical setting. However, among different etiologies, clinicians must think also to a possible rhinologic source of pain ⇓. Rhinosinusitis ⇓ or nasal anatomical abnormalities (e.g., large turbinate, concha bullosa, or septal spurs) can cause craniofacial pain through a “contact pressure point” mechanism between opposite mucosal surfaces ⇓. At present, the diagnosis is made mainly by identifying rhinogenic causes, but its pathogenesis is still under debate as well as the therapeutic options. We report the case of a 55-year-old woman presenting an atypical facial pain started 3 weeks after dental implant positioning on right maxillary incisor region. Pain attacks were characterized by a right recurrent orbitozygomatic pounding hurt associated to ipsilateral dull “sense of pressure.” Patient's symptoms were reported as moderate to severe, lasting hours, exacerbated by nasal fossa engorgement (due to the physiological nasal cycle or postural changes), and scarcely responsive to common …