Facial pain has a long list of possible causes but the diagnosis can often be made by a good history and examination. The common causes are often benign and self-limiting but it is essential not to miss those conditions that require urgent treatment - eg, temporal arteritis, or early diagnosis - eg, malignancy. There is a tendency to overdiagnose bacterial sinusitis when the real cause may be a viral upper respiratory tract infection or, much less frequently, a more serious cause of facial pain.
Sinus: sinusitis, trauma, carcinoma.
Nose: upper respiratory tract infection, nasal injury and foreign bodies.
Ear: otitis media, otitis externa.
Teeth: dental abscess.
Local soft tissue infection: cellulitis, erysipelas.
Neurological: trigeminal neuralgia, herpes zoster.
Parotid gland: mumps, other causes of parotitis, abscess, duct obstruction, calculi, tumour.
Eye: orbital cellulitis, glaucoma.
Temporomandibular joint dysfunction and pain.
Cluster headaches, migraine.
Tumours: nasopharyngeal, oral, posterior fossa, brainstem gliomas.
Bone: maxillary or mandibular osteitis, cyst.
Atypical facial pain: more common in the elderly and in women; often linked with depression.
Lung cancer (upper lobe).