The sinus headache
is usually dull, but more intense flare-ups can occur. Bending over
and coughing commonly worsen the pain immediately.
There is research evidence
indicating that headaches can be due to pressure on the nasal mucosa
from anatomical variations, nasal polyps, or mucosal swelling.
The contact points
may be, for example, between the septum and the inferior or middle
turbinates, between the middle turbinate and the uncinate process,
or between the middle turbinate and an ethmoidal bulla.
Diagnosis depends on
visualizing these contacts by coronal sinus CT and by nasal endoscopy,
and by temporarily alleviating the headache by application of a
local anesthetic at the contact point.
There have been innumerable
patients receiving unsuccessful courses of antibiotic therapy and
many patients operated on unsuccessfully for presumed sinusitis-related
therapy for headaches unaccompanied by such symptoms and before
confirming the presence of sinusitis by coronal CT images and nasal
endoscopy should generally be avoided.
Neurologists and headache
specialists often see tension-type and migraine headaches, which
are commonly felt in the region of the sinuses, misdiagnosed as
sinus headaches by both patients and their physicians.
Patients not only assume
that their headaches are from sinus problems, but treat themselves
unsuccessfully for this with non-prescription sinus medications.
An absence of upper
respiratory symptoms should make the physician consider non-sinus