Do you really have sinus headache?
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20191480Keywords:
Chronic headache, Sinus headache, Migraine, Tension type headacheAbstract
Background: Headache is a common symptom. Correct diagnosis of the etiology is the key to successful treatment. Chronic headache are misdiagnosed as sinus headache because of presence of overlapping symptoms leading to unnecessary treatment with no relief to the patient. We decided to undertake this study with the objective of evaluating patients with chronic headache for presence of chronic rhinosinusitis and hence assess the contribution of sinus headache to chronic headache.
Methods: The present study was conducted at Adichunchanagiri Institute of Medical Sciences, BG Nagara during the period January 2018 to December 2018. Patients presenting to OPD with chronic headache previously diagnosed as sinus headache were included in the study. A total of 174 patients were studied. All patients underwent detailed history taking, detailed ENT examination, and diagnostic nasal endoscopy. AAOHNS criteria for rhinosinusitis and IHS criteria for migraine and tension type headache were used for diagnosis.
Results: We found that only 13% (n=23) cases had chronic rhinosinusitis and hence diagnosed as sinus headache. 53% (n=92) had migraine, 31% (n=54) had tension type headache and 3% (n=5) could not be categorized.
Conclusions: Prevalence of sinus headache in our study was found to be 13%. There are high chances of misdiagnosing chronic headache as sinus headache because primary forms of headache can present with nasal symptoms. The AAOHNS criteria for rhinosinusitis and IHS criteria for migraine and tension type headaches are very useful and effective in making an accurate diagnosis.
Metrics
References
Kaniecki R. Headache Assessment and Management. JAMA. 2003;289(11):1430.
Jones NS. Sinus headaches: avoiding over- and mis-diagnosis. Expert Rev Neurother. 2009;9(4):439-44.
Felisati G, Lozza P, Maccari A, Scotti A, Leone M, Bussone G. The role of the ear, nose and throat specialist in diagnosing headaches. Neurol Sci. 2005;26:83–6.
Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd edn. Cephalalgia. 2004;24(1):1.
Cady RK, Dodick DW, Levine HL, Schreiber CP, Eross EJ, Setzen M, et al. Sinus Headache: A Neurology, Otolaryngology, Allergy, and Primary Care Consensus on Diagnosis and Treatment. Mayo Clin Proc. 2005;80(7):908-16.
Senbil N, Yavuz Gurer YK, Uner C, Barut Y. Sinusitis in children and adolescents with chronic or recurrent headache: a case-control study. J Headache Pain. 2008;9:33-6.
Schreiber CP, Hutchison S, Webster CJ, Ames M, Richardson MS. Prevalence of migraine in patients with a history of self-reported or physician diagnosed “sinus” headache. Arch Intern Med. 2004;164:1769-72.
Kumar P, Chawla P. A Correlative Study of Sinusitis Versus Headache Indian J Otolaryngol Head Neck Surg. 2000;52:2 .
Aaseth K, Grande RB, Vaerner KK, Lundqvist C, Russell MB. Chronic rhinosinusitis gives a ninefold increased risk of chronic headache. The Akershus Study Chronic Headache. 2010;30:152-60.
Eross E, Dodick D, Eross M. The Sinus, Allergy and Migraine Study (SAMS). Headache. 2007;47(2):213-24.
Lipton RB, Stewart WF, Liberman JN. Self-awareness of migraine:interpreting the labels that headache sufferers apply to their headaches. Neurology 2002;58:21–6.
Cady RK, Schreiber CP. Sinus headache or migraine? Considerations in making a differential diagnosis. Neurology. 2002;58:10–4.
Silberstein SD. Headaches due to nasal and paranasal sinus disease / Neurol Clin N Am. 2004;22:1-19.