Diferencial diagnosis of “sinus headache” The role of the otorhinolaryngologist

Abstract

The purpose of this review is to help the specialist in the clinical approach of patients with headaches suspected of being caused by sinusitis, but with this diagnosis not confirmed yet. First, two case reports are presented: one case describing a patient with headaches caused by intranasal mucosal contact point and the other describing a patient with a migraine. In both cases the diagnosis was not possible if it was based only on the judgment of the computed tomography, without considering the essential contribution of clinical history. After that, a systematization of the causes, the mechanisms, the diagnostic criteria and clinical approach of these headaches is presented. In particular, the role of the otolaryngologist in the diagnosis of the migraine, the most prevalent pathology, is underlined. The possibilities of a correct diagnosis and an effective treatment, sometimes a surgical treatment, in the contact point headaches, are emphasized. Finally, the importance of the recognition and of the treatment of sinonasal triggers in the resolution of some migraines is also underlined.