Pain about the head and neck is probably the commonest complaint of a patient seeking care from an otolaryngologist. Although this symptom is often very obscure, it is none the less a challenge. Fortunately, owing to the work of Wolfe, Seydell, Williams, Horton, Costen, and others, the diagnosis and treatment of many of the conditions have been placed at our finger tips.
A surprising number of patients presenting themselves to me have had pain referable to the temporomandibular joint. This symptom complex was first described by Costen in 1934.1 As Costen states, "Mandibular joint neuralgia may be considered of common occurrence and should be investigated in any case of facial pain or headache not accountable from other sources."2 Unfortunately, the condition is still overlooked, and many patients go from doctor to doctor, without obtaining relief. The pain may be so mild as to be mistaken for a chronic
PIRKEY WP. USE OF HYDROCORTISONE IN COSTEN'S SYNDROME. AMA Arch Otolaryngol. 1955;61(5):594–595. doi:10.1001/archotol.1955.00720020611011
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