Sinus Headache

Sinus headache is due to the pain of infection or allergic inflammation of the paranasal sinuses. The four types of sinusitis are:

1. Maxillary sinusitis
2. Frontal Sinusitis
3. Ethmoid sinusitis
4. Sphenoid Sinusitis

Usually the lining of the nose is affected as well, leading to the more correct term rhinosinusitis (rhin = nose).

Many people with pain between their eyes, over their cheek or forehead will self-diagnose a sinus pain, believing sinusitis to be one of the common headache causes.

However, most people who self-diagnose "sinusitis" actually have migraine. This has been shown in some large studies of people with episodes of pain in the face and nose.

These people may be greatly helped by treating their headaches as migraine instead of using decongestants and antibiotics for sinus infection.

The usual history for sinusitis is of a head cold that fails to resolve quickly. Pain in the face, nose, cheek or forehead can occur, with persistent fever.

There is usually a nasal discharge, which may be foul-smelling, give bad breath or give a foul taste in the mouth.

Treatment is usually with decongestants and antibiotics, but with severe fever or severe head pain, hospital treatment may be required with intravenous antibiotics.

The most important condition for me is Sphenoid Sinusitis, as it can present without typical sinus symptoms. It can take months to get a diagnosis, yet treatment can be effective.

References

Levine H et al. An Otolaryngology, Neurology, Allergy, and Primary Care Consensus on Diagnosis and Treatment of Sinus Headache. Otolaryngology-Head and Neck Surgery (2006) 134, 516-523. (Free Abstract only)

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