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  • Title: [Sinonasal headache--reality or mis-diagnosis?].
    Author: Hănţăscu I, Moscaliuc G, Costinescu VN.
    Journal: Rev Med Chir Soc Med Nat Iasi; 2011; 115(3):806-12. PubMed ID: 22046791.
    Abstract:
    UNLABELLED: Facial pain can be the presenting, and sometimes the only, complaint of many disorders that originate from cranial structures. One causes of facial pain/headache is sinusitis, in both its acute and its chronic presentation. Successful management of headache is preceded by the identification of an etiology and precise diagnosis. MATERIAL AND METHODS: A prospective study was carried out on a series of 71 patients treated in the ENT Department of Iasi "Sf. Spiridon" Hospital between January and august 2009 for pathology implying facial pain, headache, facial pressure, nasal obstruction, rhinorrhea. The therapy was medical and surgical and pursued nasal desobstruction, sinusal drainage and ventilation. Data regarding different parameters were analyzed pre and post therapy. RESULTS: After the proper treatment for each situation, the parameters analyzed improved significantly, although, in some cases the main accuses regarding the pain remained unchanged or slightly ameliorated. CONCLUSIONS: Depending on the clinical suspicion of the possible etiologies of facial pain and headache, the appropriate consultations should be made. For concerns of head and neck lesions or sinus-related headache, an otolaryngologist should be consulted. If a primary headache syndrome or a cranial neuralgia is of concern, the patient should be evaluated by a neurologist. Dentists and oral surgeons should be involved. In some cases, a psychiatry referral is appropriate. The surgical treatment can be effective if the pathology meets the criteria of sinonasal facial pain.
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