0:00

So this was a patient with chronic headaches. The main thing here,

0:04

and this is a bit of a tricky case,

0:06

you can always comment on the degree of perinasal sinuses,

0:10

but the main thing here was that there is a right-sided septal

0:14

deviation and see this spur right here, see it's a budding,

0:17

the right inferior turbinate and that right inferior turbinate has a paradoxical

0:22

rotation to it.

0:24

So this is something you should probably always mention on your sinus ct.

0:27

So this is sometimes referred to as slitter headaches.

0:31

So if the patient has chronic headaches, um,

0:34

and you see this abutment here of the, of the nasal SS spurt E,

0:38

either the inferior, the middle turbinate,

0:40

then that could actually be the cause of the patient's symptoms. So, um,

0:45

this is what's referred to as a, um, a contact headaches or slitter headaches.

0:52

Any questions on this one Han?

0:55

Uh, no, but it is a new diagnosis for me. I never heard before.

1:00

Okay, very good. Good learn. Yeah, it just interesting. Yeah,

1:05

I mean the pain management guys love it because I've got a friend of mine who I

1:09

used to work with, uh, in Michigan,

1:11

he works in a pain management group and they actually can do s phenyl palatine

1:14

blocks for these.

1:16

So the neurologist kinda like this diagnosis and especially they do pain

1:20

management, they can actually do, um,

1:22

a nerve block assuming all the other symptoms are confirmatory.

1:27

Manual way is the S spin Palatine gang. Is it in the tco Palatine Foa?

1:33

Yeah, exactly. It's actually gonna be a located right in here.

1:37

In fact, since you asked,

1:41

so this is the sagal images. Here's V two and then here's the ganglion here.

1:46

So that's known as the Speedo palatine and the tego palatine ganglion.

1:50

So it's located the tego palatine fossa.

1:53

So the tego palatine fossa is gonna be located right here.

1:57

Here's the normal tego palatine fossa here in white.

2:00

You see this is the fat here in the,

2:01

on the tego palatine fossa and the yellow arrows pointed at the tumor extending

2:06

back in the ter palatine fossa. And on the sagal images,

2:10

there's where the ganglion is right here. So it's in the Tego palatine ganglia.