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Nose / Sinus

Headache secondary to nose and sinus disease is not uncommon and well known patterns of headache are recognised according to the particular area of the nose and sinuses affected as well as the underlying disease process. There are four groups of sinuses: the maxillary, frontal, ethmoidal and sphenoidal sinuses. Most headaches due to nose and sinus disease are associated with other symptoms and most are due to either viral (common colds) or bacterial infection.

It is common for there to be more than one underlying cause. Hence, there is great variation in how patients present.

The following conditions are representative of nose and sinus problems which may lead to head-pain,but not all inclusive.

Rhinosinusitus

Infective rhinosinusitus

May be acute or chronic

Causes include:

Viral (common colds, flu, herpes)

Bacterial

Fungal

Syphilis, tuberculosis, rhinoscleroma (all rare)

Complications of Sinusitus:

Orbit/Eye involvement including permanent blindness

Meningitis

Brain Abscess

Diagnosis

Is based on patients description of symptoms, examination findings including endoscopy of the nose, special Xrays (CT and MRI), blood and skin prick allergy tests, microbilogy swabs to culture infecting organisms

Treatment

Topical (sprays) and oral (tablets) nasal decongestants

Salt water irrigations (various formulae recommended)

Appropriate antibiotics

Topical and oral steroids

Appropriate surgery after failure of conservative treatment

Allergic rhinitis

A well known condition, acute, seasonal or chronic (perennial), caused by an abnormal response of the nasal lining to external substances called "allergens". Related to asthma and eczema

Severe cases may cause headache, fullness and pressure, amongst other symptoms

Treated similarly to infective rhinitis except avoidance of allergens and antihistamines useful

Non-allergic rhinitis

Similar symptoms to allergic rhinitis but no evidence of allergic cause. Generally non-specific irritants (eg, atmospheric pollution)

Similarly treated to allergic rhinitis

Inflammatory rhinosinusitus

Autoimmune Disease

Wegeners

Systemic Lupus Erythematosis

Sarcoidosis

"Midline granuloma"

Hormonal rhinitis

Pregnancy - marked nasal congestion may lead to infective sinusitus during pregnancy.

Ear, Nose and Throat Problems may contribute to Headaches and Migraines so it is important to have them professionally addressed. It is also important to investigate for other potential causes, as many cases of Headaches and Migraines have more than one ingredient.

See Treatments Section (Ear,Nose,Throat)

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